ReviewThe Canadian journal of cardiology2021
Challenges and Lessons Learned From COVID-19 Trials: Should We Be Doing Clinical Trials Differently?
Review in The Canadian journal of cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Agreement of treatment effects in decentralised trials versus traditional trials: meta-epidemiological study.BMJ (Clinical research ed.) · 2025Pooled it
- Factors that influence recruitment to COVID-19 vaccine trials: a qualitative evidence synthesis.Trials · 2024Pooled it
- Use of pragmatic randomized trials in multiple sclerosis: A systematic overview.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Pooled it
- Interventions for mental health, cognition, and psychological wellbeing in long COVID: a systematic review of registered trials.Psychological medicine · 2022Pooled it
- Promoting Hand Hygiene During the COVID-19 Pandemic: Randomized Controlled Trial of the Optimized Soapp+ App.JMIR mHealth and uHealth · 2025Trial
- Trial
- Hydroxychloroquine to prevent SARS-CoV-2 infection among healthcare workers: early termination of a phase 3, randomised, open-label, controlled clinical trial.BMC research notes · 2023Trial
- Adaptive versus fixed designs in confirmatory clinical trials: centering the choice on ethics.Clinical trials (London, England) · 2026Article
- Evaluating COVID-19 vaccine effectiveness across epidemiologic designs: test-negative case-control versus retrospective cohort analyses in a nationwide study.International journal of epidemiology · 2026Article
- Implementation science and the clinical trial workforce: A national needs assessment of training and practice.Contemporary clinical trials communications · 2026Article
- A python's embrace? Insurance and the global clinical trial.Health research policy and systems · 2026Article
- How Can Pharmacology Help Us Overcome the Challenges of Drug Repositioning as Antivirals to Treat Emerging Pathogens? The Example of Covid-19.Clinical and translational science · 2026Review
- Dynamic clinical trial success rates for drugs in the 21st century.Nature communications · 2025Article
- Measuring What Matters in Trial Operations: Development and Validation of the Clinical Trial Site Performance Measure.Journal of clinical medicine · 2025Article
- Article
- Translational Success and Pharmacoeconomic Lessons of Pandemic-Driven Drug Repurposing.Cureus · 2025Review
- Co-designing and pilot-testing an infographic to support the consent process in an adaptive platform trial for adults in ICU with community-acquired pneumonia or COVID-19: a mixed methods study within a trial (SWAT).Research involvement and engagement · 2025Article
- Ethical issues and the role of the ethics committees during COVID-19 research in pandemic era: a focus on an Italian ethics committee.Frontiers in public health · 2025Article
- Article
- The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided.JAMA · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The COVID-19 crisis led to a flurry of clinical trials activity. The COVID-evidence database shows 2814 COVID-19 randomized trials registered as of February 16, 2021. Most were small (only 18% have a planned sample size > 500) and the rare completed ones have not provided published results promptly (only 283 trial publications as of February 2021). Small randomized trials and observational, nonrandomized analyses have not had a successful track record and have generated misleading expectations. Different large trials on the same intervention have generally been far more efficient in producing timely and consistent evidence. The rapid generation of evidence and accelerated dissemination of results have led to new challenges for systematic reviews and meta-analyses (eg, rapid, living, and scoping reviews). Pressure to regulatory agencies has also mounted with massive emergency authorizations, but some of them have had to be revoked. Pandemic circumstances have disrupted the way trials are conducted; therefore, new methods have been developed and adopted more widely to facilitate recruitment, consent, and overall trial conduct. On the basis of the COVID-19 experience and its challenges, planning of several large, efficient trials, and wider use of adaptive designs might change the future of clinical research. Pragmatism, integration in clinical care, efficient administration, promotion of collaborative structures, and enhanced integration of existing data and facilities might be several of the legacies of COVID-19 on future randomized trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.