Celebrity Deathmatch: Burden of disease vs. RCTs in the Southern cone of Latin America




Long oral session 14: Issues in Global Health


Thursday 14 September 2017 - 14:00 to 15:30


All authors in correct order:

Bardach A1, Belizán J1, Glujovsky D1, Ciapponi A1
1 Institute for Clinical Effectiveness and Health Policy, Argentina, Argentina
Presenting author and contact person

Presenting author:

Agustín Ciapponi

Contact person:

Abstract text
Background: It is not new that only a tiny percentage of the world’s resources for health research and development (R&D) are spent on the health problems of developing countries, which represent almost all of the world’s burden of preventable mortality. The south cone of Latin America (S-LA, Chile, Uruguay and Argentina) is no exception.

Objectives: To compare the ranking and frequency of conditions that produce a greater burden of disease according to IHME's GBD and to compare it with the ranking of those same 10 conditions regarding registration of clinical trials in the ClinicalTrial.gov database for S-LA from inception to February 2017. Also to explore sources of funding and the evolution of trends in the last four 5-year periods.

Methods: We manually reviewed the health condition or problem studied, the intervention and the primary sponsor by examining the registered record in CTGov database, for the countries specified above, and then coded the data according to ICD-10 (Table 1). We retrieved GBD rankings of DALY-producing conditions from http://vizhub.healthdata.org/gbd-compare. We also included geographically relevant conditions such as Maternal causes, Chagas disease, Dengue and TB. Analyses were done in Stata® 14.1.

Results: A total of 660 RCTs came from S-LAC considering the top DALY-producing conditions according to IHME’s GBD, out of 2744 registered in CTGov from the database (24%, Table 2). Eighty one per cent (81%) of trials were funded exclusively by the industry (Table 3). No important changes in patterns of frequency of conditions were observed in the last 20 years (Table 4).

Conclusions: This landscape study confirms little correlation between burden of disease in S-LA and the distribution of topics addressed in clinical trial research, although RCTs may capture only a small proportion of all-incident research in the countries, and this could vary according to the condition considered.