Multicenter research trials

Table of Contents

Definition

The modified definition of multicenter research trials includes clinical trials conducted at more than one medical center, clinic or medical practice. The benefits of multicenter trials include a larger and therefore more representative number of participants, different geographic locations, the possibility to include a wider range of population groups, and the ability to compare results among centers. All these points increase the generalizability of the study. In many cases, efficacy will vary significantly between population groups with different genetic, environmental, and ethnic or cultural backgrounds ("demographic" factors); normally only geographically dispersed trials can properly evaluate this [modified to Wikipedia 2008].

What has been done so far?

Multicenter studies using contrast enhanced ultrasound have been recently successfully published in the field of contrast enhanced techniques. The recently published EFSUMB-guidelines and recommendations summarise the data and provide general advice for the use of ultrasound contrast agents to improve the management of patients [Michel Claudon, David Cosgrove, Thomas Albrecht, Luigi Bolondi, Maurizio Bosio, Fabrizio Calliada, Jean-Michel Correas, Kassa Darge, Christoph Dietrich, Mirko D'Onofrio, David H Evans, Carlo Filice, Lucas Greiner, Kurt Jäger, Nico de Jong, Eddie Leen, Riccardo Lencioni, David Lindsell, Alberto Martegani, Stephen Meairs, Christian Nolsøe, Fabio Piscaglia, Paolo Ricci, Gunther Seidel, Bjoern Skjoldbye, Luigi Solbiati, Lars Thorelius, François Tranquart, Hans Peter Weskott, Tony Whittingham]. Italian multicenter trials have shown the very impressive advantages of local ablative treatment of malignant liver lesions in comparison to surgical strategies.

Recently more than 1000 histological proven liver lesions have been prospectively examined by contrast enhanced ultrasound to characterize liver tumours by initiation of DEGUM and the convincing data have been submitted for publication. A similar study has been performed in France as well. The power of the mentioned studies and many other similar activities are derived by the multicenter and sometime also interdisciplinary approach.

Other multicenter studies including different organ systems have been initiated so far, e.g. in the differentiation and differential diagnosis of pancreatic and splenic lesion, the lung and many other fields of contrast enhanced ultrasound and other techniques, e.g., Sonoelastography. Many successful multicenter studies have been initiated by individual researchers but ultrasound societies have also started to create a platform for the international community to collect, analyse and publish data. The EFSUMB platform might be particularly helpful for the smaller EFSUMB-communities to point out their impressive expertise.

As the actual Honorary Secretary of EFSUMB I am eager to challenge the scientific ultrasound community to perform more multicentre and interdisciplinary studies in the upcoming years to increase the influence of ultrasound techniques in daily practice. We have to prove all together that ultrasound is effective (and also cost effective!) under many circumstances, including the emergency room and other accesses to the hospital, in the out patients care setting and under many other circumstances.

In addition imaging features of very rare diseases can only be characterised by collecting data of many centres. Therefore, EFSUMB offers combined activities of small and large ultrasound societies. We started our section "The case of the month" at our website www.efsumb.org] and cordially invite you to join the EFSUMB-activities.

Additionally we could create a communicating multicenter platform if challenged by our members coming from so many European countries. Collecting data could also include very rare liver diseases (e.g., storage liver disease, echinococcosis), intestinal disease (e.g., intestinal tuberculosis) and many other rare and more common entities regarding different organ systems. Monitoring biological antitumour therapy strategies in the view of time intensity curve analysis and sonographic application of antitumour agents might be of special interest.

Please refer to EFSUMB and the Honorary Secretary for support and discussion.

Cordially,

Christoph F. Dietrich,

EFSUMB Honorary Secretary and member of the EFSUMB Publication Committee