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Global clinical research involves 95% of countries, with growth peaking in 2009. While non-traditional markets expand participation, traditional regions still dominate multinational trials, nearing maximum global capacity.

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Area of Science:

  • Clinical research
  • Global health
  • Health services research

Background:

  • Globalization of clinical research has increased significantly.
  • The full extent of this globalization and its drivers are not well understood.
  • Assessing the interconnectedness of countries in multinational trials is crucial.

Purpose of the Study:

  • To quantitatively assess the globalization of clinical research.
  • To analyze geographic connections and participation trends in multinational clinical trials.
  • To identify regions driving the growth and assess the overall capacity of global clinical research infrastructure.

Main Methods:

  • Utilized data from all 13,208 multinational clinical trials registered on ClinicalTrials.gov.
  • Analyzed geographic connections between individual countries participating in these trials.
  • Examined trends in globalization and regional contributions over time.

Main Results:

  • 95% (185 countries) of all countries worldwide have participated in multinational clinical research.
  • Growth in globalization peaked in 2009, indicating potential saturation of global infrastructure.
  • Increased involvement from South America and Asia is noted, but Europe, North America, and Asia dominate global connections (>85%).

Conclusions:

  • Multinational clinical research has achieved broad global participation.
  • The field may be approaching a maximum global capacity, with growth slowing since 2009.
  • Despite expansion into new markets, traditional regions continue to be the primary hubs for global clinical research.