Top UK medical research funder achieves 100% clinical trial registration

The UK Medical Research Council has released an audit report showing that 100% of the clinical trials it funded were registered, and that 91% had published their results.

MRC’s successes in improving trial registration and reporting illustrate how funders can effectively curb research waste.

Specifically, MRC adopted strong transparency policies, regularly monitored compliance, proactively followed up with non-compliant researchers, and was prepared to impose sanctions if compliance issues were not addressed.

Below are highlights from the 2024 audit report, which covers all 141 MRC-funded clinical trials that started during 2017 to 2023.

Trial registration

 

100% of trials were publicly registered in a clinical trials registry.

94% of trials that started in the last year of the review were registered before recruitment began. This compares with 56% compliance for trials awarded funding between February 2017 and January 2020. MRC states that its goal is to achieve 100% prospective registration.

Trial reporting

 

Of the 58 studies due for reporting, 91% had publicly reported their data.

Of 58 trials that had been completed two or more years ago:

• 45% had publicly reported trial findings within 12 months of completion

• 26% had publicly reported trial findings 12 to 24 months of completion

• 21% had publicly reported trial findings more than 24 months after completion

• 9% had not reported results

The report explains that:

"Compared with previous audits, the percentage of completed trials that have publicly reported the main findings within 12 months of the trial end has increased… However the percentage reporting by 24 months remains largely unchanged at 71%.”

“Of the 49 completed studies which have reported results, 47% reported the results in a registry: 28% provided a link to the main results in the ISRCTN registry entry, and 21% provided a link to the main results in another registry (not ISRCTN). 15% posted results in the registry (six of these had also linked to the main results and are represented twice in these figures). 47% did not provide a link or post results in a registry.”

Policies

 

MRC’s policies require all trials to be prospectively registered in specific registries, and their results to be made public within two years of trial end.

Monitoring

 

“Since 2017, MRC has carried out annual reviews of all trials funded by MRC to assess compliance with our policy.”

“Due to the Covid pandemic, there was a gap between 2019 and 2023. Going forward, the MRC aims to provide an audit report more frequently.”

Proactive follow-up and sanctions

 

Registration. “Since February 2020, when MRC introduced temporary suspension of funding for trials that are not registered in the ISRCTN registry or a WHO primary registry, 98% of trials have been compliant with the MRC registration policy... We contacted PIs of trials where the ISRCTN registry number was not reported to the MRC and not easily retrieved from publications or reports. After multiple reminders, we notified three PIs who had not complied that we were drafting letters of suspension and also engaged the MRC staff members who had oversight of these trials in contacting the PIs. We had a good response at this stage and the three trials were registered before we sent out any formal letters of suspension of funding." 

Reporting. “We contacted the PIs of the trials which are overdue for reporting. For three, the delay was due to staff issues and pandemic-related delays. Another PI noted that there was significant political turmoil in the country the trial took place, resulting in a delay in sample release and publication of data. All contacted PIs expect to publish their data in the coming months. This will be followed up in our next audit.”

The road ahead

Till Bruckner, founder of TranspariMED, said:

“The UK Medical Research Council has conclusively demonstrated that funders can avoid bankrolling research waste in clinical trials.”

“Beyond being good news for UK patients, this is a refreshing reminder that public sector waste can be effectively curbed without using a chainsaw. Hopefully, decision makers in other countries will take note.”

“Going forward, TranspariMED hopes that MRC will raise the bar even further and require its grantees to make trial results public within just one year, as recommended by the World Health Organisation.”

The MRC audit report including the full dataset is available online. Rachel Knowles who leads this work within MRC has published an excellent paper detailing how other funders can set up comparable monitoring systems.