Development of large, simple trials in neuropsychiatric disease
Neuropsychiatric illnesses are among the most important causes of death and disability worldwide: for example, there are ~1 million deaths/year from suicide (compared with 0.4 million from breast cancer). Despite this, there have been no appropriately large randomised trials of the management of these disorders -- and, consequently, uncertainty about the most effective treatments and wide variations in practice. The avoidance of catastrophic clinical outcomes (such as hospital readmission or suicide) in these conditions should lend itself well to the "mega-trial" approach that CTSU has established in other areas.
Hence, in collaboration with the Oxford Department of Psychiatry, several thousand patients are to be randomised in trials of alternative maintenance treatments in bipolar disorder and of alternative durations of maintenance therapy in unipolar depression. By demonstrating the value of this approach, these studies could then lead to a series of large, streamlined trials providing clear answers in neuropsychiatric disease.
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