[[{“value”:”A nice catch by Max at Maximum Progress: [A common critique] is that the NIH funds too many “small crappy trials.” That quote is from a FDA higher up, but the story has been repeated by many others…I downloaded all of the clinical trial data from ClinicalTrials.gov to find out….The median NIH funded trial has 48 participants while the median industry
The post The NIH Doesn’t Fund Small Crappy Trials appeared first on Marginal REVOLUTION.”}]]
A nice catch by Max at Maximum Progress:
[A common critique] is that the NIH funds too many “small crappy trials.” That quote is from a FDA higher up, but the story has been repeated by many others…I downloaded all of the clinical trial data from ClinicalTrials.gov to find out….The median NIH funded trial has 48 participants while the median industry funded trial has 67. The average NIH funded trial has 288 participants while the average industry trial has 335 and the average “Other” funded trial (mostly universities and the associated hospitals) has 923 participants.
By median or by average NIH trials are the smallest out of all the funders. This seems to confirm the “small crappy trials” narrative
…This narrative is reversed, however, when you split up the trials by phase.
Across all trials NIH funded ones are the smallest, but within each phase NIH trials are the largest or second largest. Their overall small enrollment average is just due to the fact that they fund more Phase I trials than Phase III. But NIH Phase I trials have a bigger sample size than industry funded trials on average.
This is an example of Simpson’s Paradox in the wild!
Arguing that the NIH should stop funding unusually small trials is easy but arguing that they should shift from funding the Phase I trials closest to basic research towards later stage trials is less clear.
The NIH’s clinical trial strategy is certainly not perfect and improving it is valuable. But a systematic bias towards “small crappy trials” doesn’t really seem like it’s an important problem facing the NIH.
The post The NIH Doesn’t Fund Small Crappy Trials appeared first on Marginal REVOLUTION.
Current Affairs, Data Source, Medicine
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