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Views & Reviews Review of the Week

Behind the pages of clinical research

BMJ 2009; 339 doi: (Published 09 December 2009) Cite this as: BMJ 2009;339:b5359
  1. Allen Shaughnessy, professor of family medicine, Tufts University School of Medicine, Boston, Massachusetts
  1. Allen.Shaughnessy{at}

    Two new books contrast in their approach to the investigation of clinical trials but both take a meandering route, finds Allen Shaughnessy

    Boston, where I live, seems like one big research lab waiting room. Recruitment placards adorn subway walls, quarter page advertisements dot the daily newspapers, and radio broadcasts are sprinkled with spots asking whether I am a “male between the ages of 25 and 50 years who has . . .” I am constantly reminded of the commercial aspects of investigational drug research.

    As described in its introduction, When Experiments Travel “is about the business of clinical trials.” Specifically it chronicles the shift of drug industry sponsored studies in the United States out of (primarily) academic medical centres to private offices of contract research organisations. It also traces the move of research out of the US and western Europe to emerging markets in eastern Europe, Asia, and South America, where 40% of all clinical trials are now performed.

    The reasons for this shift are many, as are the intended and unintended results. The need for study participants has mushroomed in the past 20 years. The US and western Europe simply don’t have enough people to enter all the studies of drugs in development. Regulatory agencies require potential new drugs to be …

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