Worldwide clinical interventional studies on leading causes of death: a descriptive analysis

Abstract

Purpose: To describe the global effort of clinical studies conducted on leading causes of death.

Methods: Sixteen leading causes of death were chosen. "Interventional" "open" (i.e., recruiting or not yet recruiting) studies, by sponsorship (Industry [INY], universities and other organizations [UNO], NIH, and other U.S. Federal Agencies [OTH]), intervention (e.g., drugs, behavior, devices, diet), worldwide, and those conducted in the top 11 countries in clinical research were identified in ClinicalTrials.gov.

Results: Twenty-three percent of all (5851/24964) "open" trials were conducted on the diseases considered. UNO, INY, NIH, and OTH accounted for 68%, 34%, 15%, and 3%, of these studies, respectively. Forty-five percent of all studies were on diabetes (20%), trachea, bronchus and lung cancers (14%), and HIV/AIDS (11%); <4% were on diarrhea, tuberculosis, and malaria. The rest were on ischemic heart disease (10%), colon and rectum cancers (10%), lower respiratory infections (7%), hypertensive heart disease (7%), cerebrovascular disease (6%), chronic obstructive pulmonary disease (4%), stomach cancer (3%), prematurity and low birth weight (2%), and cirrhosis of the liver (2%). Nephritis and nephrosis accounted for less than 1%. In most studies the investigators assessed drugs (66%) or procedures (24%).U.S. sites participated in 44% of all studies. Twenty-four percent were cosponsored studies; 33% of these were on cancers. Thirty-eight percent of HIV/AIDS studies were cofunded.

Conclusions: Clinical research efforts are unevenly allocated, depending on the interest developed countries had on each of the diseases considered. A dramatic change is needed aiming to focus efforts on those diseases that need greater attention globally.