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Standardizing in vitro diagnostics tasks in clinical trials: a call for action
Giuseppe Lippi1, Ana-Maria Simundic1, Leocadio Rodriguez-Manas1
11 Working Group on Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM); 2 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 3 Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia ; 4 Department of Geriatrics, Hospital Universitario de Getafe, Getafe, Spain ; 5 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, and STARD (Standards for Reporting of Diagnostic Accuracy) group, Amsterdam, the Netherlands ; 6 IRCCS Galeazzi and Vita e Salute San Raffaele University, Milan, Italy.
Many early-phase translational research studies fail due to practical issues like poor diagnostic testing and lab quality, wasting resources. Improving clinical trial success requires multidisciplinary collaboration and evidence-based biospecimen management.
Area of Science:
- Biomedical Research
- Translational Science
- Clinical Trials
Background:
- Translational research aims to apply basic science discoveries to human disease treatment and prevention.
- A significant percentage of early-phase studies fail to yield tangible clinical benefits, often due to practical rather than theoretical limitations.
- Suboptimal diagnostic testing and poor laboratory quality control can lead to biased results, misinterpretations, and wasted resources in clinical research.
Purpose of the Study:
- To identify practical reasons for the failure of translational research studies.
- To highlight the economic impact of preanalytical and analytical issues in clinical trials.
- To propose solutions for improving the success rate of translational research.
Main Methods:
- The study reviews evidence on factors affecting translational research outcomes.
- It analyzes the causes of preanalytical and analytical problems in laboratory testing within clinical trials.
- It discusses the economic implications of these issues in the European Union.
Main Results:
- Up to 95% of early-phase studies may not translate into clinical benefits.
- Preanalytical and analytical problems in laboratory testing contribute to study failures.
- An estimated over 10 million euros are lost annually in EU clinical trials due to these issues.
- Heterogeneity in guidelines, lack of evidence for requirements, and poor stakeholder integration exacerbate the problem.
Conclusions:
- Practical issues, particularly in diagnostic testing and laboratory quality, significantly impede translational research success.
- Addressing these issues requires standardizing guidelines, strengthening the evidence base for laboratory practices, and fostering collaboration among diverse stakeholders.
- Developing multidisciplinary teams involving researchers, clinicians, patients, and diagnostic companies is crucial for improving biospecimen management and enhancing clinical trial outcomes.
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