Evidence map›Paper›PMID 40533806›Full record

ArticleTrials2025

CLIMATRIAL: applicability and adaptability of a novel method to quantify the carbon footprint of a South African clinical trial.

Nandi Louise Siegfried, Lesley-Ann Erasmus-Claassen, Jessica Griffiths, Lisa Fox, Paula R Williamson

Abstract read
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
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

5 authors.

Nandi Louise SiegfriedMental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa. nandi.siegfried@mrc.ac.za.
Lesley-Ann Erasmus-ClaassenMental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa.
Jessica GriffithsClinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK.
Lisa FoxClinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK.
Paula R WilliamsonDepartment of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK.

Funding

Directorate-General for International Partnerships RE-CL-2023-09
6 · The paper itself

Abstract

backgroundNo formal assessment of a method to measure the carbon emissions from a clinical trial has been undertaken in the low- and middle-income country setting. We aimed to evaluate the UK-based National Institute of Health Research (NIHR) method for tracking trial emissions for applicability and adaptability to the South African context. Objectives included to (1) identify gaps in trial activity data, (2) locate local emission factor sources, (3) quantify emissions and (4) investigate modifications required to ensure the method was locally applicable.

methodWe adopted an application and implementation approach. We established a formal stakeholder structure focused on sustainable clinical trials to guide and support our approach. We selected a large cluster-randomised trial of a health service delivery intervention conducted across multiple urban and rural sites as an exemplar typical of local conditions to test the NIHR method. We created a trial process map outlining ten recommended activity stages for carbon emissions and an Excel workbook to calculate emissions for each stage. We prioritised calculations of those activities for which we had the most complete data: paper usage and printing, local travel between sites, and electricity consumption at the trial head office and at trial sites. We extracted activity data from organisational financial instruments.

resultsThe study took place between December 2023 and March 2024. We identified a lack of publicly available local emission factor sources. Paper usage and printing activities took place at trial set-up and during intervention delivery and emitted 2274.88 kgCO

conclusionWe found that with minor modifications, the NIHR guidance is applicable to the SA context. It is a highly adaptable framework permitting tracking of activities across trial stages. A lack of locally available emission factors reduces accuracy and emission results should be viewed as indicative.

Indexed as

Carbon FootprintRandomized Controlled Trials as TopicHumansSouth AfricaCarbon emissionsCarbon tracking toolsTrials

Identifiers

PMID40533806
PMCPMC12177951

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.