Abstract

Purpose : The purpose of this study was to compare clinical trials’ methodological quality between developing and developed countries, and its correlation with human development index.

Data Sources : We systematically searched the PUBMED electronic database for published controlled clinical trials conducted in heart failure. Results were filtered using the “clinical trials” filter and dated from January 2009 to December 2013.


Study Selection : From the 416 articles, 61 articles that met the selection criteria were selected. Each article was screened independently for inclusion by two independent raters.

Data extraction : Out of the 61 included articles, 53 were from developed countries and only 8 were from developing countries. Each article was assessed for their quality by five independent raters using the JADAD quality scale.


Results : Median quality score for developed countries was 3 (range 0-5), while for developing countries was 1.5 (range 0-4) (p-value 0.04). There is a statistically significant correlation between quality scores and the human development index (HDI) (rho= 0.275, p-value = 0.032). The only significant correlation between HDI indices and quality score was for education index (rho = 0.381, p-value = 0.003).


Conclusions and Relevance : Our study indicated that there is a difference between the developing and the developed countries in terms of quantity and quality of clinical trials, mainly due to differences in the educational status. Based on that, we recommend to incorporate research in the curricula of the undergraduate medical education in developing countries and to initiate collaborative clinical research courses.


Key-Words : Clinical trial quality, developing countries, developed countries, JADAD scale, human development index, heart failure.