Towards integrative, patient-centred clinical research

Patient-oriented clinical research has improved in the past twenty years thanks to public investment in several initiatives (e.g. the creation of clinical trial units (CTUs), the establishment of the Swiss Clinical Trial Organisation (SCTO), local clinical MD-PhD programmes, and the Swiss Group for Clinical Cancer Research (SAKK) regional networks project), infrastructures (e.g. data warehouses, biobanks, analytic platforms, the Swiss Personalized Health Network (SPHN), and the Swiss Biobanking platform (SBP)), and support instruments (e.g. Swiss National Science Foundation (SNSF) grants for longitudinal studies, funding for investigator-initiated clinical trials (SNSF’s IICT programme), and the SAMS and Bangerter Foundation’s joint programme Young Talents in Clinical Research (YTCR)).

However, these efforts have also led to a fragmentation of activities, and deficits remain – including limited integration and harmonisation of processes within and between institutions, insufficient involvement of patients, a lack of incentives to choose a career in clinical research, weak multidisciplinary and interdisciplinary research, and uncertain sustainable funding for research infrastructures and early career researchers. Moreover, despite the high quality of medical care in Switzerland, Swiss clinical research still lags behind basic and experimental research and behind clinical research in leading countries when compared internationally.

Written on behalf of the State Secretariat for Education, Research and Innovation (SERI), the White Paper: Clinical Research analyses the major driving forces that are transforming clinical research and identifies current weaknesses in clinical research in Switzerland. Based on the notion that good care comes with – and from – good science, the white paper calls for a transformation of the clinical research culture in hospitals and related research institutions so as to make it more integrative at all levels.

The white paper also provides a roadmap that outlines the following seven goals and constitutes an action plan for change to make Switzerland an international leader in patient-centred clinical research:

1. Create a national platform to coordinate publicly funded stakeholders in clinical research.
2. Establish strong partnerships with society, the public, and patients.
3. Promote a healthcare system that systematically integrates clinical research: good care comes with – and from – good science.
4. Invest in the development of innovative and dynamic clinical research approaches, designs, and technologies enabled by digital tools.
5. Strengthen translational, multidisciplinary, and integrated clinical research teams.
6. Create an environment that is attractive to clinical and health researchers and support them at all career levels.
7. Increase the efficiency of clinical research and accelerate its delivery by reducing the complexity of regulatory and data-related processes.

In order to increase the benefit of research to society as a whole, patients and the public should be involved in strategic discussions and funding decisions related to clinical research. Along with innovation and novelty, evaluation criteria for research grants should include addressing unmet medical needs and achieving patient-relevant outcomes. In addition, public campaigns should emphasise both the value of partnerships between scientists, patients, and the public and the importance of clinical research for high-quality healthcare. Moreover, initiatives to create a national framework for patient and public involvement and empowerment need to be promoted and coordinated.

A PDF of the White Paper: Clinical Research can be downloaded or a printed copy can be ordered free of charge on the SAMS website. The website also contains information on creating a national coordination platform to strengthen the interaction between all public stakeholders of clinical research and integrating the perspective of public health.