JAMA Network Open Study Identifies Priorities for Better Clinical Trials

A qualitative study published in JAMA Network Open identified several steps that international trial stakeholders said could improve the informativeness of randomized clinical trials.

The study focused on trial informativeness, a framework that includes whether a trial addresses an important question, uses an appropriate design, is feasible, maintains scientific integrity, and reports results fully and accurately. The authors wrote that poorly designed, conducted, or reported trials may contribute to research waste and limit the usefulness of clinical evidence.

Researchers conducted semistructured, one-on-one interviews with 55 professionals involved in the funding, design, sponsorship, regulatory oversight, or ethical review of randomized clinical trials. Interviews were conducted online between October 2024 and March 2025. Participants came from 16 countries across 5 continents, with the largest groups based in the United States and the United Kingdom. Investigators made up 38.2% of participants, and funders accounted for 21.8%.

According to the authors, trial design generated the greatest number of insights. Participants highlighted the need for additional scientific design review after peer review but before a funding commitment, as well as the importance of including qualified trial statisticians. Other themes included early and meaningful patient partnerships, stronger skills-based training beyond good clinical practice, and more rigorous feasibility planning for recruitment and retention.

The authors reported that 24 interviewees, or 43.6%, identified design-related issues when asked to name one action that could improve trial informativeness. They also emphasized that trials should be registered, results reported transparently, and findings disseminated in ways that support public trust and decision-making.

The authors concluded that improving trial informativeness is both a scientific and ethical priority, requiring greater attention from investigators, funders, approval agencies, regulators, journal editors, and others involved in randomized clinical trials.

Source: Prowse SR, Brazzelli M, Green HR, Treweek S. International stakeholder guidance for improving informativeness of randomized clinical trials. JAMA Netw Open. 2026;9(6):e2619487. doi:10.1001/jamanetworkopen.2026.19487