Clinician-researcher's perspectives on clinical research during the COVID19 pandemic

Abstract

Objectives: The outcome of well-performed clinical research is essential for evidence-based patient management during pandemics. However, conducting clinical research amidst a pandemic requires researchers to balance clinical and research demands. We seek to understand the values, experiences, and beliefs of physicians working at the onset of the COVID-19 pandemic in order to inform clinical research planning. We aim to understand whether pandemic settings affect physician comfort with research practices, and how physician experiences shape their understanding of research in a pandemic setting.

Methods: A survey tool was adapted to evaluate familiarity and comfort with research during a pandemic. A cross-sectional, online questionnaire was distributed across Canadian research networks early in the COVID-19 outbreak. The survey was administered between March 11th and 17th, 2020, during a time of local transmission but prior to the surge of cases. We aimed to recruit into the survey physicians in infectious disease and critical care research networks across Canada.

Results: Of the 133 physician respondents, 131 (98%) considered it important to conduct clinical research during the COVID-19 pandemic. Respondents were more accepting of adaptations to the research process in during a pandemic compared to in a non-pandemic setting, including conducting research with deferred consent (χ2 = 8.941, 95% CI: -0.264, -0.085, p = 0.003), using non-identifiable observational data with a waiver of consent with a median score of 97 out of 100 (IQR: 79.25-100) vs median 87 out of 100 (IQR: 63-79) (95% CI: -12.43, 0.054, p = 0.052). The majority felt that research quality is not compromised during pandemics.

Conclusions: Physicians consider it important to conduct research during a pandemic, highlighting the need to expedite research activities in pandemic settings. Respondents were more accepting of adaptations to the research process for research conducted during a pandemic, compared to that conducted in its absence of a pandemic.

Fig 1. Comparison of comfort with research practices in pandemic and non-pandemic settings.

(A) Comfort randomizing patients using deferred consent for an unproven medication, in which participants were more comfortable in pandemic settings than non-pandemic settings. (B) Comfort randomizing patients to a current therapy with routine data collection follow up, under a waiver of consent, which did not differ amongst participants between pandemic and non-pandemic settings.