ArticleBMJ open2023
Carbon footprint of industry-sponsored late-stage clinical trials.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 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
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Strategies and tactics to reduce the impact of healthcare on climate change: systematic review.BMJ (Clinical research ed.) · 2024Pooled it
- Oncology drug development in the UK: analysis of the past 25 years and focus on the 2026 reboot of the clinical trial regulatory framework.British journal of cancer · 2026Article
- Measuring the carbon footprint of clinical research activities: a scoping review of measurement tools and methods.BMJ open · 2026Article
- Article
- Evaluating the Environmental Impact of Clinical Research: A Full Life Cycle Analysis of a French Academic Randomised Clinical Trial.Fundamental & clinical pharmacology · 2026Article
- Quantification and reduction of the health sector's environmental impact.Bulletin of the World Health Organization · 2026Article
- Assessing the carbon footprint of French academic clinical trials using the NIHR method.BMJ open · 2025Article
- Stepping Stones to Sustainability Within Cancer Clinical Trials in Ireland.Current oncology (Toronto, Ont.) · 2025Article
- Article
- Carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis.BMJ open · 2025Article
- Integrating Sustainability Pillars Into Trial Design Decision-Making: Results of an International Survey.Clinical and translational science · 2025Article
- Viewpoint: a white paper for a greener design, conduct and reporting of clinical trials in respiratory medicine.The European respiratory journal · 2025Article
- Article
- Phase 2a, Randomized Trial of Mitiperstat Versus Placebo in Patients with COPD at High Risk of Exacerbation (CRESCENDO).International journal of chronic obstructive pulmonary disease · 2025Article
- Climate change and cancer care: impacts and implications for patients and healthcare professionals.Ecancermedicalscience · 2025Article
- What is the carbon footprint of academic clinical trials? A study of hotspots in 10 trials.BMJ open · 2024Article
- An urgent call for environmental accountability in nephrology clinical trials.Clinical kidney journal · 2024Article
- Quantifying the carbon footprint of clinical trials: guidance development and case studies.BMJ open · 2024Review
- A Fully Decentralized Randomized Controlled Study of As-Needed Albuterol-Budesonide Fixed-Dose Inhaler in Mild Asthma: The BATURA Study Design.Journal of asthma and allergy · 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
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo quantify the carbon footprint from a sample of pharma industry sponsored phase III trials. To develop an approach that can readily be applied to future trials by AstraZeneca and other trial sponsors.
designLife cycle assessment including all the sources of carbon emissions associated with a completed, an ongoing and a planned clinical trial. The methodology followed the guidance on appraising the sustainability of Care Pathways, developed by the UK National Health Service in collaboration with parties across the healthcare system.
settingThree multicentre late phase trials. One completed heart failure trial, one ongoing oncology trial and one asthma trial with the addition of devices to be representative of current practice.
participantsThe three trials had a total number of 7412 participants.
main outcome measuresTotal carbon emissions from each trial, the drivers of those emissions and the emissions per patient.
resultsThe total carbon footprint for the cardiovascular trial was calculated as 2498 tonnes carbon dioxide equivalents (CO
conclusionsWe have shown that it is feasible to perform a retrospective life cycle assessment to appraise the carbon footprint of large clinical trials and confirmed that phase III trials result in significant emissions. Having identified all the drivers of emissions and their magnitude, we are well placed to develop a plan for achieving net-zero carbon clinical trials. Now it is possible to expand the use of life cycle assessment to planned studies so that scientific aims can be achieved with a minimum of carbon emissions. We encourage other trialists to apply the same methodology as a necessary first step in reducing the carbon footprint of clinical trials.
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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.