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Determining research priorities for clinician-initiated trials in infectious diseases

Randomised controlled trials (RCTs) are accepted as the best type of study to assess the effects of health care interventions and therefore have a pivotal role in evidence-based medicine.1 A new paradigm is emerging whereby RCTs are now being undertaken by a network of clinicians.2

Clinician-initiated RCTs have several features that differentiate them from industry-sponsored studies. They are more likely to compare generically available, off-patent medications, or to study processes of care or non-pharmacological interventions. As clinician-initiated trials are financially independent of industry, with their funding source being governmental research organisations (eg, the National Health and Medical Research Council [NHMRC]), the results are viewed by clinicians as more credible.3 The NHMRC has already demonstrated a willingness to fund clinician-initiated RCTs, as shown by the success of networks such as the Australian and New Zealand Intensive Care Society Clinical Trials Group.47 The impact of their successfully completed trials on practice change, cost savings and improved…