Behrooz Astaneh: Trial registry – the Iranian experience

Behrooz AstanehClinical trials are the cornerstone of medical research. Multiple publications of the results of a specific trial as well as non-publication of unfavorable results are among the problems facing the medical literature. To avoid such problems, the idea of trial registries has been proposed, and nowadays authors cannot publish the results of trials in most reputable journals without prior registration.

Medical research has increased greatly in Iran during the last few years. Consequently editors of Iranian medical journals have started to encuonter similar problems (such as multiple publications) as their European or American counterparts. When I was speaking for the first time about the trial registration process, which had become mandatory in the UK some months before, to some participants in a medical journalism workshop in Shiraz (south of Iran) in 2006, the audience obviously thought that the idea seemed very strange and might increase the amount of bureaucracy. However, the idea spread around the country and caught on very rapidly.

After the WHO primary registry network had been established and, having considered the few approved trial registries worldwide, a group of authorities in the Iranian Ministry of Health and Medical Education independently worked on establishing the Iranian registry (IRCT). With the collaboration of scientists from various universities, the registry received considerable input to become reality and be approved by WHO.

As an Iranian editor, I received an official guideline from the Ministry in February 2009, noting that all authors wishing to publish their trials in Iranian journals have to register these with the Iranian registry before patients are selected. The new law will take effect from January 2010.

The registry is bilingual (Persian and English), which enables researchers from any other countries to register their trials solely in English. Although trials done outside Iran can be published in Iranian journals if they were previously registered in other approved registries, trials conducted in Iran that are to be published in Iranian journals must be registered in the Iranian registry (in Persian) even they are already registered in other approved registries (the ID of the existing registry should be reported). This fact might be interesting for those non-Iranian scientists who wish to perform multicenter studies in countries including Iran. To publish the related part of those trials in Iran, their Iranian co-authors have to register their trials in Iran too. The logic behind this approach is to prepare a database of the information about the trials that are going to be performed in Iran – for example, the Iranian arm of the multicenter studies in Iran for those Iranian researchers or public bodies who are not fluent in English.

I think the cultural aspect of this registry is the most important part. This aspect is the move towards transparency in research, which most journal editors feel is necessary. Surely there is still a long way to go towards full public collaboration and use, but the way should be paved.

Behrooz Astaneh M.D., visiting editor BMJ

Competing interest: I know personally the organizers of this registry and have talked to them to clarify some ambiguities about the registry before writing the blog. Some parts of the writing were changed based on their explanations. However no financial relation exists.