Australian researchers are calling for the
open sharing of clinical trial data in the medical research community, saying
it would be instrumental in eliminating bottlenecks and duplication, and lead
to faster and more trustworthy evidence for many of our most pressing health
problems.
Moreover,
hackers should be role models for freeing up access to the "source
code" of clinical trials – patient-level data – the researchers from the
University of New South Wales (UNSW) in Sydney argue in a commentary published
in the journal Science Translational Medicine.
Hackers
revolutionised the software industry by countering the economic and cultural
motivations that drove closed source software and disengagement from user
needs.
"Similar
roadblocks plague the clinical evidence domain where, despite a rapid increase
in the volume of published research, physicians still make decisions without
access to the synthesised evidence they need," said paper co-author, UNSW
Australian Institute of Health Innovation Research Fellow, Dr Adam Dunn.
The
call follows a wider push for free, open access to academic publications and
intellectual property rights designed to turn more university research into
real-world applications.
Open
source communities often out-perform their closed source counterparts, most
notably in the software community where millions of programmers contribute code
that can be used for free, by anyone.
"If
the same principles were applied to medical research, bottlenecks, biases and
self-interest would be largely removed," said Professor Enrico Coiera, a
co-author on the paper along with UNSW Professor Ric Day, and Professor Kenneth
Mandl from Harvard Medical School.
"Clinical trial data is
a potential goldmine. If researchers, doctors and patients were able to
re-analyse and pool this data, there would be a host of questions that could
start to be answered. But these meta-analyses are very uncommon because
researchers and companies don't like to share data," Professor Coiera
said.
"One
solution, which has no support, is for data to be pirated. No one would win in
that scenario. But everyone could be a winner if clinical research data went
open source."
While
there are technical challenges around building an open source community for clinical trials,
including important considerations around privacy and data quality, "these
could be easily overcome", Dr Dunn said.
Less
easy to overcome are the social and financial barriers. "Most researchers
want to hold their data as long as they can as the basis for
publications," Dr Dunn said. "And unfortunately, pharmaceutical
companies want to control the messages that are delivered to doctors and
maximise profits rather than facilitate the cost-effective delivery of
care."
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