Evidence map›Paper›PMID 29566721›Full record

SynthesisInternational journal for equity in health2018

Barriers for conducting clinical trials in developing countries- a systematic review.

Chalachew Alemayehu, Geoffrey Mitchell, Jane Nikles

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal for equity in health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 228 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
228citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

228 citing papers in PubMed, 14 syntheses or guidelines pooled it.

  1. Diagnostic challenges and treatment barriers in the management of diffuse intrinsic pontine glioma in low- and lower-middle-income countries: a systematic review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
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  2. Interventions to prevent obesity in children aged 2 to 4 years old.The Cochrane database of systematic reviews · 2025
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  6. Interventions to prevent obesity in children aged 12 to 18 years old.The Cochrane database of systematic reviews · 2024
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168 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Chalachew AlemayehuFaculty of Medicine University of Queensland, Brisbane, Australia. bestchale@yahoo.com.
Geoffrey MitchellFaculty of Medicine University of Queensland, Brisbane, Australia.
Jane NiklesThe University of Queensland Centre for Clinical Reseaerch (UQCCR), Brisbane, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical trials for identification of efficient and effective new diagnostic and treatment modalities are needed to address disproportionately high burden of communicable (e.g., HIV/AIDS, tuberculosis, and malaria) and non-communicable diseases (e.g., diabetes) in developing countries. However, gross under-representation in global clinical trial platforms contributes to sustained health inequity in these countries. We reviewed the literature on barriers facing clinical researchers in developing countries for conducting clinical trials in their countries.

methodsLiterature indexed in PubMed, Embase, CINAHL and Web of Science, WHO Global Health Library were searched. Grey literature was also searched. Search key words included barriers, challenges, clinical trials and developing countries. Articles within the scope of this review were appraised by two reviewers.

resultsTen studies, which are reported in 15 papers, were included in this review. Following critical review we identified five unifying themes for barriers. Barriers for conducting clinical trials included lack of financial and human capacity, ethical and regulatory system obstacles, lack of research environment, operational barriers and competing demands. CONCLUSION AND RECOMMENDATION: There were substantial barriers at system, organization and individual level. We propose that to address this problem, instituting a system for wider implementation of local investigator-initiated trials is warranted. These trials are more applicable to local populations because they build on local healthcare knowledge. They are more demand-led, influence policy and responsive to a country's needs because they are driven by a local or national agenda.

Indexed as

Attitude to HealthCommunication BarriersDeveloping CountriesClinical Trials as TopicHumansResearch Support as TopicBarriersClinical trialsDeveloping countries

Identifiers

PMID29566721
PMCPMC5863824

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.