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Current Perspective| Volume 183, P90-94, April 2023

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The safety risk of information overload and bureaucracy in oncology clinical trial conduct

Published:January 27, 2023DOI:https://doi.org/10.1016/j.ejca.2023.01.018

      Highlights

      • Regulatory aspects regarding clinical trials increased substantially over time.
      • These regulations seem to cause information overload and ineffective bureaucracy.
      • Information overload and bureaucracy may distract from essential safety information.
      • We give insight in clinical trial regulations, evaluating practical consequences.
      • We propose specific improvements for optimal clinical trial conduct.

      Abstract

      Performance of clinical trials has led to major therapeutic developments and substantial improvements in the field of medical oncology. To ensure patient's safety, regulatory aspects for proper clinical trial conduct have been increased over the past two decades but seem to cause information overload and ineffective bureaucracy, possibly even impacting patient safety. To put this in perspective, after the implementation of Directive 2001/20/EC in the European Union, a 90 per cent increase in trial launching time, a 25 per cent decrease in patient participation and a 98 per cent rise in administrative trial costs were reported. The time to initiate a clinical trial has increased from a few months to several years in the past three decades. Moreover, there is a serious risk that information overload with relatively unimportant data endangers the decision-making processes and distracts from essential patient safety information. It is now a critical moment in time to improve efficient clinical trial conduct for our future patients diagnosed with cancer. We are convinced that a reduction of the administrative regulations, information overload, and simplification of the procedures for trial conductance may improve patient safety. In this Current Perspective, we give insight in the current regulatory aspects of clinical research, evaluate the practical consequences of these regulations, and propose specific improvements for optimal clinical trial conduct.

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