title: New approaches to trials in glomerulonephritis.
abstract: Randomized controlled trials are required to reliably identify interventions to improve the outcomes for people with glomerulonephritis (GN). Unfortunately, although easier, observational studies are inherently unreliable even though the findings of both study designs agree most of the time. Currently there are ∼790 trials in GN, but suboptimal design and reporting, together with small sample sizes, mean that they may not be reliable for decision making. If the history is somewhat bleak, the future looks bright, with recent initiatives to improve the quality, size and relevance of clinical trials in nephrology, including greater patient engagement, trial networks, core outcome sets, registry-based trials and adaptive designs. Given the current state of the evidence informing the care of people with GN, disruptive technologies and pervasive culture change is required to ensure that the potential of trials to improve the health of people with this complex condition is to be realized.
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Centre for Kidney Research, Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Centre for Kidney Research, Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Tong
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Centre for Kidney Research, Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia.|Diaverum Medical Scientific Office, Lund, Sweden.|Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.|Diaverum Academy, Lund, Sweden.|University of Bari, Bari, Italy.
authors.forename: Giovanni F M
authors.initials: GF
authors.lastname: Strippoli
mesh_terms: D003657:Decision Making; D019468:Disease Management; D005921:Glomerulonephritis / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012107:Research Design / Q000592:standards*
keywords: decision making; epidemiology; glomerulonephritis; randomized controlled trials; review