title: In global health research, is it legitimate to stop clinical trials early on account of their opportunity costs?
abstract: After the failure of three large clinical trials of vaginal microbicides, a Nature editorial stated that the microbicide field "requires a mechanism to help it make rational choices about the best candidates to move through trials" [1]. In this month's debate, James Lavery and colleagues propose a new mechanism, based on stopping trials early for "opportunity costs." They argue that microbicide trial sites could have been saturated with trials of scientifically less advanced products, while newer, and potentially more promising, products were being developed. They propose a mechanism to reallocate resources invested in existing trials of older products that might be better invested in more scientifically advanced products that are awaiting clinical testing. But David Buchanan argues that the early stopping of trials for such opportunity costs would face insurmountable practical barriers, and would risk causing harm to the participants in the trial that was stopped.
authors.affiliation: Centre for Research on Inner City Health and Centre for Global Health Research, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada. jim.lavery@utoronto.ca
authors.forename: James V
authors.initials: JV
authors.lastname: Lavery
authors.forename: Peter A
authors.initials: PA
authors.lastname: Singer
authors.forename: Renee
authors.initials: R
authors.lastname: Ridzon
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Singh
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Slutsky
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Anisko
authors.forename: David
authors.initials: D
authors.lastname: Buchanan
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D035843:Biomedical Research / Q000941:ethics; D002986:Clinical Trials as Topic / Q000941:ethics; D015507:Drugs, Investigational / Q000627:therapeutic use*; D006801:Humans; D012107:Research Design; D035842:Research Subjects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D015507:Drugs, Investigational