On making clinical trials possible

Abstract

In this issue, we are publishing two contributions deserving of special note. Courtesy of the inimitable David Sackett, we are inaugurating a new column devoted to career advice for the cliniciantrialist, a career path that has become increasingly difficult for many of the reasons that Sackett attempts to address in this series [1]. You will see that the tone and content of the column, like its author, is informal, irreverent, wise, but overall, real. He talks about the life and career management skills that are needed to foster success in this field, in which clinician investigators are desperately needed to assure that clinical trials are asking the right questions, but professional, economic, and social pressures are making it increasingly difficult for them to choose this path. While Sackett's advice will make the biggest difference for those early in their careers, this non-early-career trialist can testify that it is never too late to receive it. Sackett has all the bona fides to offer such advice, but more importantly, an endless wellspring of good humor and a passionate commitment to nurturing the next generation of clinician researchers. I welcome him to our pages, and look forward to his jovially serious wisdom over at least the next year.Going from the micro to the macro scale, we have the fortuitous pairing of two articles in this issue on the regulatory and legal barriers to conducting international, multicenter clinical trials, one by my illustrious predecessor at this journal, Jim Neaton [2,3]. As Yusuf [4] highlights in his editorial, these barriers, while arising from good intentions, are in fact undermining much of the good that the research is designed to promote. This is explored in depth in the article by Bollyky. It is adapted from a report prepared for the Washington, DC-based Center for Global Development, a quasi-academic think tank whose aim is to try to maximize the salutary impact of development aid on the health and welfare of people in the developing world. What differentiates their focus from that of academia is their commitment to and skills at the translation of ideas into policy action. That is seen in Bollyky's report, which documents not just the problem, but

An interview with David Sackett, 2014–2015

“…Steve Goodman introduced the series thus as follows: 31 Courtesy of the inimitable David Sackett, we are inaugurating a new column devoted to career advice for the clinician-trialist, a career path that has become increasingly difficult for many of the reasons that Sackett attempts to address in this series. You will see that the tone and content of the column, like its author, are informal, irreverent, wise, but overall, real.…”