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?:abstract
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Coronavirus Disease 2019 (COVID-19) is a rapidly evolving global pandemic for which more than a thousand clinical trials have been registered to secure therapeutic effectiveness, expeditiously Most of these are single-center non-randomized studies rather than multi-center, randomized controlled trials Single-arm trials have several limitations and may be conducted when spontaneous improvement is not anticipated, small placebo effect exists, and randomization to a placebo is not ethical In an emergency where saving lives takes precedence, it is ethical to conduct trials with any scientifically proven design, however, safety must not be compromised A phase II or III trial can be conducted directly in a pandemic with appropriate checkpoints and stopping rules COVID-19 has two management paradigms- antivirals, or treatment of its complications Simultaneous assessment of two different treatments can be done using 2 × 2 factorial schema World Health Organization\'s SOLIDARITY trial is a classic example of the global research protocol which can evaluate the preferred treatment to combat COVID-19 pandemic Short of that, a trial design must incorporate the practicality of the intervention used, and an appropriate primary endpoint which should ideally be a clinical outcome Collaboration between institutions is needed more than ever to successfully execute and accrue in randomized trials
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