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Editor's Note
Integrating Clinical Trials and Practice
ܲԱ3, 2024

Integrating Clinical Trials and Practice: A New JAMA Series and Call for Papers

Author Affiliations
  • 1Executive Editor, JAMA
JAMA. Published online June 3, 2024. doi:10.1001/jama.2024.10266

Randomized clinical trials remain the cornerstone of evidence-based medicine. As a leading medical journal publishing the science that advances the clinical care of patients and the health of the public, JAMA is committed to the publication of clinical trials, as well as promoting the discourse on how clinical trial evidence can best serve the needs of patients and clinicians.

In autumn of 2023, JAMA hosted its inaugural in-person JAMA Summit1 on the topic of randomized clinical trials and the challenges and opportunities to improve their design and conduct to be most responsive to the needs of clinical practice. The Special Communication published in JAMA,2 “The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided,” was written on behalf of the participants in the JAMA Summit and outlines many of the themes discussed during this provocative 2-day meeting.

A central theme of the JAMA Summit, which is elaborated on in the Special Communication in this issue, is how best to integrate clinical trials with clinical practice. Traditionally, clinical trialists and clinicians have worked independently, and, as the authors of the Special Communication underscore, their separate missions, incentives, and infrastructures have been siloed. The result is inefficiency in the performance of trials and limitations in their scope and impact. The authors offer solutions, including advances in implementation science, novel approaches to statistical analysis of trial data, and integration of trials with the electronic health record as a very rich source of clinical data. The clinical trial and health care delivery disciplines have functioned as a house divided. The authors proffer an approach to bridging the gap.

The future of clinical medicine will be greatly influenced by the data derived from randomized clinical trials, and trials will need to be accomplished more quickly, efficiently, and cheaply than they are today. A recent example is the platform trials3 that were conducted during the COVID-19 pandemic.4-6 These trials were embedded within clinical care and permitted the study of multiple therapeutic interventions simultaneously, with the results applicable to patient care in short order. The platform trials are exemplary of the types of novel approaches to clinical trials that are needed to realign the house divided.

With this Special Communication and an accompanying Viewpoint,7 we launch a new series in Ѵ—Integrating Clinical Trials and Practice. JAMA invites submissions that explore innovations in clinical trial design, implementation, funding, regulation, education, and application that may bring randomized trial evidence to more effectively address the needs in clinical practice. Our goal is to engage the research community in a significant publishing project to advance clinical trials and better align them with clinical practice. We welcome articles of any type, and we are happy to hear from you with presubmission inquiries. We are eager to chart a new path for randomized clinical trials and the delivery of health care, and we hope you will participate in navigating the road ahead.

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Article Information

Published Online: June 3, 2024. doi:10.1001/jama.2024.10266

Corresponding Author: Greg Curfman, MD, JAMA, Editorial Office, 330 N Wabash Ave, Chicago, IL 60611 (gregory.curfman@jamanetwork.org).

Conflict of Interest Disclosures: None reported.

References
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Bibbins-Domingo  K, Angus  DC, Park  H,  et al.  Introducing the JAMA Summit.  Ѵ. 2024;331(17):1451. doi:
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Angus  DC, Huang  AJ, Lewis  RJ,  et al.  The integration of clinical trials with the practice of medicine: repairing a house divided.  Ѵ. Published online June 3, 2024. doi:
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Park  JJH, Detry  MA, Murthy  S, Guyatt  G, Mills  EJ.  How to use and interpret the results of a platform trial: users’ guide to the medical literature.  Ѵ. 2022;327(1):67-74. doi:
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Higgins  AM, Berry  LR, Lorenzi  E,  et al; Writing Committee for the REMAP-CAP Investigators.  Long-term (180-day) outcomes in critically ill patients with COVID-19 in the REMAP-CAP randomized clinical trial.  Ѵ. 2023;329(1):39-51. doi:
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Adhikari  NKJ, Hashmi  M, Tirupakuzhi Vijayaraghavan  BK,  et al; LOVIT-COVID Investigators, on behalf of the Canadian Critical Care Trials Group, and the REMAP-CAP Investigators.  Intravenous vitamin C for patients hospitalized with COVID-19: two harmonized randomized clinical trials.  Ѵ. 2023;330(18):1745-1759. doi:
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Abbasi  AB, Curtis  LH, Califf  RM.  Why should the FDA focus on pragmatic clinical research?  Ѵ. Published online June 3, 2024. doi:
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