Definition
The modified definition of multicenter research trials includes clinical trials conducted
at more than one medical center, clinic or medical practice. The benefits of multicenter
trials include a larger and therefore more representative number of participants,
different geographic locations, the possibility to include a wider range of population
groups, and the ability to compare results among centers. All these points increase
the generalizability of the study. In many cases, efficacy will vary significantly
between population groups with different genetic, environmental, and ethnic or cultural
backgrounds ("demographic" factors); normally only geographically dispersed trials
can properly evaluate this [modified to Wikipedia 2008].
What has been done so far?
Multicenter studies using contrast enhanced ultrasound have been recently successfully
published in the field of contrast enhanced techniques. The recently published EFSUMB-guidelines
and recommendations summarise the data and provide general advice for the use of ultrasound
contrast agents to improve the management of patients [Michel Claudon, David Cosgrove,
Thomas Albrecht, Luigi Bolondi, Maurizio Bosio, Fabrizio Calliada, Jean-Michel Correas,
Kassa Darge, Christoph Dietrich, Mirko D'Onofrio, David H Evans, Carlo Filice, Lucas
Greiner, Kurt Jäger, Nico de Jong, Eddie Leen, Riccardo Lencioni, David Lindsell,
Alberto Martegani, Stephen Meairs, Christian Nolsøe, Fabio Piscaglia, Paolo Ricci,
Gunther Seidel, Bjoern Skjoldbye, Luigi Solbiati, Lars Thorelius, François Tranquart,
Hans Peter Weskott, Tony Whittingham]. Italian multicenter trials have shown the very
impressive advantages of local ablative treatment of malignant liver lesions in comparison
to surgical strategies.
Recently more than 1000 histological proven liver lesions have been prospectively
examined by contrast enhanced ultrasound to characterize liver tumours by initiation
of DEGUM and the convincing data have been submitted for publication. A similar study
has been performed in France as well. The power of the mentioned studies and many
other similar activities are derived by the multicenter and sometime also interdisciplinary
approach.
Other multicenter studies including different organ systems have been initiated so
far, e.g. in the differentiation and differential diagnosis of pancreatic and splenic
lesion, the lung and many other fields of contrast enhanced ultrasound and other techniques,
e.g., Sonoelastography. Many successful multicenter studies have been initiated by
individual researchers but ultrasound societies have also started to create a platform
for the international community to collect, analyse and publish data. The EFSUMB platform
might be particularly helpful for the smaller EFSUMB-communities to point out their
impressive expertise.
As the actual Honorary Secretary of EFSUMB I am eager to challenge the scientific
ultrasound community to perform more multicentre and interdisciplinary studies in
the upcoming years to increase the influence of ultrasound techniques in daily practice.
We have to prove all together that ultrasound is effective (and also cost effective!)
under many circumstances, including the emergency room and other accesses to the hospital,
in the out patients care setting and under many other circumstances.
In addition imaging features of very rare diseases can only be characterised by collecting
data of many centres. Therefore, EFSUMB offers combined activities of small and large
ultrasound societies. We started our section "The case of the month" at our website
www.efsumb.org] and cordially invite you to join the EFSUMB-activities.
Additionally we could create a communicating multicenter platform if challenged by
our members coming from so many European countries. Collecting data could also include
very rare liver diseases (e.g., storage liver disease, echinococcosis), intestinal
disease (e.g., intestinal tuberculosis) and many other rare and more common entities
regarding different organ systems. Monitoring biological antitumour therapy strategies
in the view of time intensity curve analysis and sonographic application of antitumour
agents might be of special interest.
Please refer to EFSUMB and the Honorary Secretary for support and discussion.
Cordially,
Christoph F. Dietrich,
EFSUMB Honorary Secretary and member of the EFSUMB Publication Committee
