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Making trials part of good clinical care: lessons from the RECOVERY trial.
Future Healthc J. 2021 Jul; 8(2):e243-e250.FH

Abstract

When COVID-19 hit the UK in early 2020, there were no known treatments for a condition that results in the death of around one in four patients hospitalised with this disease. Around the world, possible treatments were administered to huge numbers of patients, without any reliable assessments of safety and efficacy. The rapid generation of high-quality evidence was vital. RECOVERY is a streamlined, pragmatic, randomised controlled trial, which was set up in response to this challenge. As of April 2021, over 39,000 patients have been enrolled from 178 hospital sites in the UK. Within 100 days of its initiation, RECOVERY demonstrated that dexamethasone improves survival for patients with severe disease; a result that was rapidly implemented in the UK and internationally saving hundreds of thousands of lives. Importantly, it also showed that other widely used treatments (such as hydroxychloroquine and azithromycin) have no meaningful benefit for hospitalised patients. This was only possible through randomisation of large numbers of patients and the adoption of streamlined and pragmatic procedures focused on quality, together with widespread collaboration focused on a single goal. RECOVERY illustrates how clinical trials and healthcare can be integrated, even in a pandemic. This approach provides new opportunities to generate the evidence needed for high-quality healthcare not only for a pandemic but for the many other conditions that place a burden on patients and the healthcare system.

Authors+Show Affiliations

Nuffield Department of Population Health, Oxford, UK and Oxford University Hospitals NHS Foundation Trust, Oxford, UK. joint first authors.Nuffield Department of Population Health, Oxford, UK and Oxford University Hospitals NHS Foundation Trust, Oxford, UK. joint first authors.Nuffield Department of Population Health, Oxford, UK.Centre for Tropical Medicine and Global Health, Oxford, UK.Nuffield Department of Population Health, Oxford, UK, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, NIHR Oxford Biomedical Research Centre, Oxford, UK and Health Data Research UK, Oxford, UK.Nuffield Department of Population Health, Oxford, UK, Oxford University Hospitals NHS Foundation Trust, Oxford, UK and Health Data Research UK, Oxford, UK.Nuffield Department of Population Health, Oxford, UK, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34286192

Citation

Pessoa-Amorim, Guilherme, et al. "Making Trials Part of Good Clinical Care: Lessons From the RECOVERY Trial." Future Healthcare Journal, vol. 8, no. 2, 2021, pp. e243-e250.
Pessoa-Amorim G, Campbell M, Fletcher L, et al. Making trials part of good clinical care: lessons from the RECOVERY trial. Future Healthc J. 2021;8(2):e243-e250.
Pessoa-Amorim, G., Campbell, M., Fletcher, L., Horby, P., Landray, M., Mafham, M., & Haynes, R. (2021). Making trials part of good clinical care: lessons from the RECOVERY trial. Future Healthcare Journal, 8(2), e243-e250. https://doi.org/10.7861/fhj.2021-0083
Pessoa-Amorim G, et al. Making Trials Part of Good Clinical Care: Lessons From the RECOVERY Trial. Future Healthc J. 2021;8(2):e243-e250. PubMed PMID: 34286192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Making trials part of good clinical care: lessons from the RECOVERY trial. AU - Pessoa-Amorim,Guilherme, AU - Campbell,Mark, AU - Fletcher,Lucy, AU - Horby,Peter, AU - Landray,Martin, AU - Mafham,Marion, AU - Haynes,Richard, PY - 2021/7/21/entrez PY - 2021/7/22/pubmed PY - 2021/7/22/medline KW - COVID-19 KW - RECOVERY KW - evidence-based medicine KW - quality-by-design KW - randomised controlled trials SP - e243 EP - e250 JF - Future healthcare journal JO - Future Healthc J VL - 8 IS - 2 N2 - When COVID-19 hit the UK in early 2020, there were no known treatments for a condition that results in the death of around one in four patients hospitalised with this disease. Around the world, possible treatments were administered to huge numbers of patients, without any reliable assessments of safety and efficacy. The rapid generation of high-quality evidence was vital. RECOVERY is a streamlined, pragmatic, randomised controlled trial, which was set up in response to this challenge. As of April 2021, over 39,000 patients have been enrolled from 178 hospital sites in the UK. Within 100 days of its initiation, RECOVERY demonstrated that dexamethasone improves survival for patients with severe disease; a result that was rapidly implemented in the UK and internationally saving hundreds of thousands of lives. Importantly, it also showed that other widely used treatments (such as hydroxychloroquine and azithromycin) have no meaningful benefit for hospitalised patients. This was only possible through randomisation of large numbers of patients and the adoption of streamlined and pragmatic procedures focused on quality, together with widespread collaboration focused on a single goal. RECOVERY illustrates how clinical trials and healthcare can be integrated, even in a pandemic. This approach provides new opportunities to generate the evidence needed for high-quality healthcare not only for a pandemic but for the many other conditions that place a burden on patients and the healthcare system. SN - 2514-6645 UR - https://www.unboundmedicine.com/medline/citation/34286192/Making_trials_part_of_good_clinical_care:_lessons_from_the_RECOVERY_trial. L2 - https://doi.org/10.7861/fhj.2021-0083 DB - PRIME DP - Unbound Medicine ER -
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