Multi-centre clinical respiratory research: a new approach?

BACKGROUND: Recruitment to clinical trials organised by the research committee of the British Thoracic Society (BTS) has declined. We suspected that this was due to increasing workloads for consultant physicians in the National Health Service (NHS). We investigated possible causes in study 1 and a possible solution in study 2. METHODS: Study 1--a questionnaire was sent to BTS members listing possible factors that might deter them from entering patients into trials. These were scored on a 0-5 scale. Study 2--we set up 13 panels of experts to cover all major fields of respiratory medicine. They were asked to design projects that would address the most important research questions that could be answered by multi-centre clinical trials. We sent 11 projects for scoring to consultant members of the BTS who were asked to score them on scientific merit and on their ability to contribute patients to the study. RESULTS: Study 1--of the 59% of consultants who responded, 77% said that competition with increasing demands on their time was the major reason for not participating. Study 2--40% of consultants returned project scores. Three projects were subsequently selected for grant application. CONCLUSIONS: Clinical research in the UK is under threat from increasing workloads on consultants. One solution to this problem is a national approach to commission major projects. The most important clinical research questions might then still be answered in the limited time available to consultants.