Clinical pharmacologists in research
It is now clear that the systems we have in place, both in academic research and in the industry, are not well suited for emergencies when immediate answers are required by our colleagues standing bed side and by those in charge of making policy decisions. The academic world is used to grant applications, reviews, publications and more reviews. The system emphasises quality over speed, proper methodology over quick answers. Can clinical pharmacology contribute to development of procedures for future emergencies? Can we perhaps make do with non-blinded studies? What randomisation is good enough? Are we happy with surrogate outcomes? Clinicaltrials.gov returns 262 studies on the role of hydroxychloroquine and/or chloroquine in COVID-19 (3). Most of them are single centre, of questionable methodological quality. At a time when there were already millions of confirmed cases with tens of thousands recovered, many of whom were treated, we were still struggling to find answers. It wasn’t until the results of the RECOVERY trial that we got high quality data (4). Clinical pharmacologists could play a key role in coming up with a framework for rapid ”real world” trials that could provide us with answers in future emergencies.