Advancing Clinical Trials: A Call for Systemic Reform

In their JAMA Health Forum article, Johns Hopkins University affiliated authors Melinda B. Buntin, Ph.D., Otis W. Brawley, MD, and Joshua M. Sharfstein, MD, propose a transformative approach to clinical trial infrastructure in the United States. Arguing that the current inefficiencies in trial financing and organization hinder progress in patient care, the authors advocate for a unified, robust research system modeled after the National Cancer Institute&rsquo;s cooperative groups and center designations. Such a framework, they argue, would prioritize diverse patient participation, foster collaboration across institutions, and enable large, impactful trials while addressing underrepresented areas such as respiratory diseases and pediatric care.
The authors point to the potential benefits of centralized infrastructure, including reduced redundancy, accelerated research, and improved equity.