What are the main inefficiencies in trial conduct? A survey of staff at registered clinical trials units

Results There were 43 respondents from 25 registered CTUs; one third were trial managers. From grant award to first participant R&D approvals were reported as a top inefficiency by 23 respondents, contracts by 22 and other approvals by 13. Site selection, feasibility, piloting at site, and site training were also issues. From recruitment of first patient to publication the top inefficiency was recruitment targets not met, with data collection (including CRF design) the next most common, followed by writing up. Delays in approvals for new sites and poor planning were also issues.