Abstract
Background: The results of completed clinical trials build the backbone of evidence-based medicine and inform the design and review of future trials. Many investigations, however, have found that a large proportion of trial results are not disseminated or disseminated with a substantial delay. For most clinical trials, university medical centres (UMCs) take the academic lead. The UMC-specific proportion of timely disseminated trial results thus becomes a "responsible metric" that can inform alternative national and international benchmarking of UMCs. Methods: We sampled and tracked all registered trials for all German UMCs that were officially completed between 2009 and 2013. We present our results in several formats, including percentages, Kaplan-Meier graphs and logistic regression modelling. The results, together with an interactive website, benchmark all German UMCs with regard to their performance in results dissemination. Results: We identified and tracked 2,132 clinical trials. For 1,509 trials, one of the 36 German UMCs took the academic lead. Of these 1,509 "lead trials", 39% published their results via journal publications or summary results in a timely manner (<24 months after completion date). This publication rate varied from 20% to 64% across all 36 German UMCs. More than six years after study completion, 26% of all eligible lead trials still had not disseminated results, accounting for an average of more than 8,000 trial participants each year that were included in trials without any knowledge gain. Conclusion: Despite substantial attention to the topic in the last decade, there is still a delay or even absence of results dissemination of trials, which is unethical, wastes public resources, and negatively affects decision making in medical research and health care. German UMCs have many unique opportunities to improve this situation. The timely dissemination of trial results should become a principle of "Good Scientific Practice" guidelines and play a role in institutional reward and incentive schemes. Funders may consider dissemination practices when reviewing applications for clinical studies. Further research should evaluate whether and how a transparent benchmarking of UMC performance in trial results dissemination and other "responsible metrics" helps to increase value and reduce waste in medical research.
