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Updated: Oct 7, 2025
Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Resilient Clinical Trial Infrastructure in Response to the COVID-19 Pandemic: Lessons Learned from the TOGETHER
Jamie I Forrest1,2, Angeli Rawat2, Felipe Duailibe2
1Platform Life Sciences, Vancouver, Canada.
Abstract:
In response to the COVID-19 pandemic, clinical research groups across the world developed trial protocols to evaluate the safety and efficacy of treatments for COVID-19. Despite this initial enthusiasm, only a small portion of these protocols were implemented. Of those implemented, a fraction successfully recruited their target sample size to analyze and disseminate findings. More than a year and a half into the COVID-19 pandemic, only a few clinical trials evaluating treatments for COVID-19 have generated new evidence. Productive randomized platform clinical trials evaluating COVID-19 treatments may attribute their success to intentional investments in developing resilient clinical trial infrastructures. Health system resiliency discourse provides a conceptual framework for characterizing attributes for withstanding shocks. This framework may also be useful for contextualizing the attributes of productive clinical trials evaluating COVID-19 therapies. We characterize the successful attributes and lessons learned in developing the TOGETHER Trial infrastructure using a health system resiliency framework. This framework may be considered by clinical trialists aiming to build resilient trial infrastructures capable of responding rapidly and efficiently to global health threats.
Insights
Many COVID-19 clinical trials failed to recruit participants. The TOGETHER Trial
Area of Science:
- Clinical Research
- Epidemiology
- Health Systems
Background:
- The COVID-19 pandemic spurred numerous clinical trials for treatments.
- However, few trials successfully recruited participants and generated evidence.
- This highlights challenges in clinical trial implementation during global health crises.
Purpose of the Study:
- To identify attributes of successful COVID-19 treatment clinical trials.
- To apply a health system resiliency framework to understand trial infrastructure.
- To share lessons learned from the TOGETHER Trial for future pandemic preparedness.
Main Methods:
- Utilized a health system resiliency framework.
- Analyzed the development of the TOGETHER Trial infrastructure.
- Characterized successful attributes and lessons learned.
Main Results:
- Successful clinical trials, like the TOGETHER Trial, benefited from intentional investments in resilient infrastructures.
- A health system resiliency framework can characterize attributes for withstanding shocks in clinical trials.
- Lessons learned focus on building adaptable and efficient trial capabilities.
Conclusions:
- Resilient clinical trial infrastructures are crucial for effective pandemic response.
- The health system resiliency framework offers valuable insights for trial design.
- This approach can enhance the capacity of clinical trials to address global health threats.
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