Question: Do health trusts/services/clinics that are research active (intensive), have better health outcomes (mortality/reduced symptoms/reduced recovery time) than trusts/services/clinics that do less or no research?

Answer:

No definite clinical implications can be made from the available evidence. It does appear, however, that lower mortality rates are observed in institutions that are involved in clinical trials although this does not necessarily demonstrate a causal relationship. The authors of a systematic review suggested that there might also be beneficial effects for patients who receive non-trial treatment from practitioners or in institutions that take part in trials. They stated that the reasons for this difference were unclear, and the relatively small amount of research on this subject and the possible influence of confounding by patient characteristics mean that this conclusion should be viewed with caution and is not robust enough to influence practice.

The authors of the systematic review also suggested that more research is needed to identify and minimise factors that might influence differences between patients treated by trial practitioners or in trial institutions compared to those treated elsewhere. They also suggested that larger numbers of patients, practitioners and institutions should be included in future studies to have sufficient power to detect moderate differences.