Perpetual observational studies: new strategies to support efficient implementation of observational studies and randomized trials in infectious diseases.

Abstract

Emerging infectious diseases are a growing threat, through population growth , increased trade and travel , urbanization , deforestation , and climate change [1]. Clinical research in response to emerging infectious diseases is challenging; selecting and contracting the appropriate study sites for a trial is time consuming, and often too few patients can be timely recruited to acquire high-quality evidence about the best treatment strategies [2]. In 2014, the EU-funded PREPARE project (Platform foR European Preparedness Against (Re-)emerging Epidemics ) was initiated to rapidly respond to severe infectious diseases outbreaks . It initiated two adaptive platform trials, the REMAP-CAP [3] and the ALIC4E trial [4], determining the effectiveness of multiple treatment strategies for a single disease . The REMAP-CAP trial was designed for a pandemic of severe community-acquired pneumonia and expanded globally during the COVID-19 pandemic. It has already delivered 10 important conclusions for better treatment of COVID-19 [3].