Faster, cheaper, more efficient: Building Canada’s capacity for pragmatic clinical trials

laptop, microscope, and a group of petri dishes on a laboratory stand

By Houda Houbeish

A training program designed to help Canada implement faster, cheaper and more efficient pragmatic clinical trials kicks off today, bringing more than 75 scholars, physicians, and researchers together to learn from leading Canadian experts.

Pragmatic trials test solutions as they would be delivered in routine care. Instead of relying on specialized research staff and independent data collection at participating sites, pragmatic trials use existing health-care staff to deliver solutions and often leverage real-world data sources needed for the trial. This allows them to be done more efficiently than traditional trials.

The program will coach researchers through the complex art of conducting these trials as part of a pan-Canadian effort to manage current and future health threats. Schulich School of Medicine & Dentistry is coordinating and hosting the program embedded within Health Data Research Network (HDRN) Canada. The team received $3.48 million from the Canadian Institutes of Health Research (CIHR) to deliver the program.

“There is a tremendous unrealized opportunity to use Canada’s rich administrative data sources to conduct large pragmatic randomized trials. Done well, they yield valid and highly generalizable results – faster than traditional trials and at a fraction of the cost,” said Dr. Amit Garg, associate dean of Clinical Research at Schulich Medicine & Dentistry, who is leading the training program. “However, few researchers in Canada have the training and experience to conduct pragmatic trials, and we are hoping to change that.”

Garg, who is also a nephrologist at London Health Sciences Centre (LHSC) and a scientist at Lawson Health Research Institute, has experience in the design, implementation, analysis and interpretation of pragmatic trials. 

The two-year virtual program – the first formal training program of its kind in Canada – brings learners from more than 30 areas of expertise together to better understand how to run efficient and effective pragmatic trials. The goal is to give participants all the information they will need to conduct a pragmatic trial in future, from understanding the basics of trial design to trial implementation, statistical analysis, quality control and oversight and other trial components.

Amit_Headshot.jpg Dr. Amit Garg, Associate Dean, Clinical Research

“This program offers medical researchers a unique opportunity to gain training and experience in conducting research that addresses the most important questions for patients and health-care practitioners,” said Dr. Jessica Spence, assistant professor in the Department of Anesthesia at McMaster University who will play a key mentorship role in the program.

As part of the program, participants will have access to specialized training that aims to enhance their knowledge and awareness of racial biases, Indigenous voices and stories, the impact of colonization on Indigenous health, and culturally safe health research practices. The goal is to remove barriers to clinical trials, maximizing their capacity for impact by making trials more equitable through improved access to all Canadians, including those living in rural or remote communities. 

“This program will … enable me to generate evidence for populations that are typically excluded from traditional randomized trials. Additionally, I will be able to identify and test interventions that could enhance prescribing practices and assess the effectiveness of repurposing drugs - medications initially used for different indications,” said Dr. Flory Muanda, a pharmacoepidemiologist and assistant professor in the Department of Physiology and Pharmacology at Schulich Medicine who is participating in the program. “I am thrilled to connect with globally recognized experts in the field of pragmatic trials.”