Authors: Bosinski et al.
The Daily Dose, IARS, Friday, May 8, 2026
Key Points
Clinical trials networks depend on both personal relationships and formal research infrastructure.
Successful collaboration often starts through meetings, presentations, follow-up conversations, and shared interest in meaningful research questions.
Formal networks can expand access to partner sites, mentor early-career investigators, and create opportunities for secondary analyses.
The United States faces major barriers to efficient multicenter trials, including high overhead, contract delays, staffing instability, and limited per-patient reimbursement.
International models, especially in the United Kingdom, show how prefunded research staff, master agreements, and platform-trial infrastructure can accelerate high-impact clinical research.
Summary
This IARS Daily Dose article reviewed a clinical trials roundtable from the 2026 IARS and SOCCA Annual Meeting focused on how to build stronger and more effective clinical trials networks. The discussion brought together investigators from the United States, Canada, the United Kingdom, and other research settings to examine how perioperative researchers can collaborate more effectively, overcome structural barriers, and conduct larger, more rigorous studies.
A central theme of the session was that successful trials begin with relationships. Panelists emphasized that personal connections remain essential, even in the presence of formal research networks. Attending meetings, presenting trial ideas or data, and following up with interested colleagues are still practical ways to identify motivated partner sites. Smaller per-patient-funded studies can also help investigators build experience and momentum before moving into larger and more complex multicenter trials.
The article also explained how formal networks add value. They allow investigators to reach beyond their own institutions, identify new collaborators, mentor junior faculty, and create opportunities for secondary analyses from ongoing trials. These secondary-use projects can help early-career researchers gain experience and keep sites engaged even when they are not the primary enrolling center. In this way, clinical trials networks can function not only as enrollment structures, but also as training platforms and idea incubators.
A major part of the discussion focused on the operational differences between the United States and other countries. US sites often require large teams of coordinators, research assistants, and regulatory staff, yet still struggle with high overhead costs, contract negotiation delays, limited per-patient reimbursement, and difficulty retaining experienced personnel. By contrast, Canadian and UK sites often operate with leaner teams because research personnel and master agreements are more likely to be supported by broader government or institutional infrastructure.
Panelists noted that even well-funded grants may leave little room after institutional indirect costs. One example involved a device trial paying approximately $1,000 to $1,500 per patient, yet sites still had to subsidize coordinator time. This type of financial pressure can reduce enrollment, slow study completion, and leave trials underpowered. To address these challenges, some centers have used surgical residents during research years, biomedical engineering students, undergraduate thesis students, gap-year students, and postbaccalaureate students. These models can work well when trainees are paired with experienced coordinators who maintain quality, regulatory oversight, and research culture.
The UK RECOVERY trial was discussed as an example of what strong infrastructure can accomplish. During the pandemic, the United Kingdom was able to rapidly answer multiple clinical questions because it already had portfolio hospitals, funded research staff, and master agreements that reduced the burden of contract negotiation. The article suggested that similar investment in the United States could help perioperative research become more efficient and sustainable.
The roundtable also emphasized the importance of pragmatic trial design. Investigators were encouraged to collect only the data needed to answer the main research question, rather than adding unnecessary observational components, biospecimen collection, or extra variables that increase workload and may never be analyzed. Simpler trial designs can reduce cost, improve enrollment, and make participation more feasible for busy clinical sites.
Looking forward, participants called for searchable databases that match investigators with sites based on infrastructure and patient populations, greater institutional support to retain high-performing research staff during funding gaps, and continued advocacy for platform-trial models. The session closed with the message that clinical trials networks are not a substitute for personal relationships, but they can multiply the power of those relationships by adding structure, scale, and sustainability.
What You Should Know
This article is especially relevant for anesthesia investigators who want to participate in or lead multicenter perioperative trials. The main message is that large clinical trials require more than a good idea. They require relationships, infrastructure, efficient design, committed sites, experienced coordinators, and sustainable funding models.
For early-career researchers, the article highlights the importance of attending meetings, presenting ideas, finding mentors, joining networks, and looking for secondary-analysis opportunities. For departments and institutions, it reinforces that research staff should not be viewed only as temporary grant-funded employees. Stable coordinators and research nurses are core infrastructure if a department wants to conduct high-quality clinical trials.
Overall, the article argues that the future of perioperative research depends on combining personal trust with formal network structure. That combination can help anesthesia investigators overcome funding, staffing, and regulatory barriers while producing the large trials needed to improve patient care.
Thank you to IARS and The Daily Dose for allowing us to summarize and share this article.