I have previously written about how to search for clinical trials, describing the difference between Phase I, II and III trials, as well as how to use the US National Institutes of Health Clinical Trials database (http://clinicaltrials.gov/). However, the fact it's currently very difficult to find out what trials are going on in the country as a whole. What's missing is a central database of all clinical trials. A step in the right direction is the UK Clinical Trials Gateway (http://www.ukctg.nihr.ac.uk/default.aspx).
While not a central registry itself, the UKCTG does enable the user to search a number of international registries through the site. Users can search on specific diseases (e.g. a specific type of cancer, like lung cancer), specific drugs (e.g. celecoxib) or other forms of therapy (e.g. photodynamic therapy), as well as combinations such as "celecoxib AND cancer". For each record returned by the search you can find out whether the trial is recruiting patients, where the trial is taking place and more details on the actual treatment itself. For patients looking for a trial it's a really useful place to start.
However, there is still room for a central registry of clinical trials. Not only would it provide doctors and patients with a single database to query for all trials in the UK, it would also allow us to track the level of activity for different diseases. For example doing a query on the UKCTG shows that there are no trials for osteosarcoma in the UK, which is sad if true, but I know that there are some trials on-going at the moment (the SUCCEED trial, run by Merck and Ariad Pharmaceuticals).
Just as importantly a central registry will enable us to see what trials are aiming to do, what protocol they use and what outcomes they are tracking. With this information we can see which trials publish their results, and also see whether they succeed in what they set out to do or whether they changed what they say they are looking for in order to present the best possible gloss on their results. And yes, this is something that does happen...
Until then, at least the UKCTG provides us with yet another useful tool to help patients and their doctors find appropriate clinical trial information.