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Prof. Dr. Dr. Matthias Briel

Department of Clinical Research
Profiles & Affiliations

Clinical Epidemiology, Public Health & Health Systems

Matthias Briel is a physician and clinical epidemiologist with a strong interest in clinical trial methodology and meta-epidemiological research. He received his Dr. med. from the University of Freiburg for electrophysiological work on cystic fibrosis in 2000, completed an MSc in Health Research Methodology at McMaster University in Hamilton, Canada in 2008, his FMH in Prevention and Public Health in 2014, and a PhD in Epidemiology in 2018.

Selected Publications

Amstutz, Alain, Schönenberger, Christof M., Speich, Benjamin, Griessbach, Alexandra, Schwenke, Johannes M., Glasstetter, Jan, James, Sophie, Verkooijen, Helena M., Nickolls, Beverley, Relton, Clare, Hemkens, Lars G., Chammartin, Frédérique, Gerber, Felix, Labhardt, Niklaus D., Schandelmaier, Stefan, & Briel, Matthias. (2024). Characteristics, consent patterns, and challenges of randomized trials using the Trials within Cohorts (TwiCs) design - A scoping review. Journal of Clinical Epidemiology, 174. https://doi.org/10.1016/j.jclinepi.2024.111469

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Griessbach, Alexandra, Schönenberger, Christof Manuel, Taji Heravi, Ala, Gloy, Viktoria, Agarwal, Arnav, Hallenberger, Tim Jonas, Schandelmaier, Stefan, Janiaud, Perrine, Amstutz, Alain, Covino, Manuela, Mall, David, Speich, Benjamin, & Briel, Matthias. (2024). Characteristics, Progression, and Output of Randomized Platform Trials: A Systematic Review. 7, E243109. https://doi.org/10.1001/jamanetworkopen.2024.3109

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Amstutz, Alain, Speich, Benjamin, Mentré, France, Rueegg, Corina Silvia, Belhadi, Drifa, Assoumou, Lambert, Burdet, Charles, Murthy, Srinivas, Dodd, Lori Elizabeth, Wang, Yeming, Tikkinen, Kari A O, Ader, Florence, Hites, Maya, Bouscambert, Maude, Trabaud, Mary Anne, Fralick, Mike, Lee, Todd C, Pinto, Ruxandra, Barratt-Due, Andreas, et al. (2023). Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials. The Lancet Respiratory Medicine, 11(5), 453–464. https://doi.org/10.1016/S2213-2600(22)00528-8

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Selected Projects & Collaborations

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MARTA: Making clinical trials more affordable - systematic investigation of trial costs and tool development

Research Project  | 1 Project Members

Randomized clinical trials (RCTs) are an essential method of evaluating health care interventions and a cornerstone for evidence-based health care. Their conduct, in particular for investigator-initiated RCTs, has long involved many practical challenges, challenges that have become increasingly complex and costly. Efforts to render RCTs more cost-effective are, therefore, urgently needed. Identifying lever-points for cost reductions requires knowledge of cost structures and cost drivers (e.g. recruitment duration, sample size, therapeutic area, number of trial sites). The medical literature, however, currently lacks detailed empirical data addressing costs and resource use of investigator-initiated RCTs as well as information about current practices of budget planning and cost monitoring, attitudes, needs, and preferences of trial investigators, trial support organizations (e.g. Clinical Trial Units), and funding agencies. Academic investigators usually depend on scarce financial resources; user-friendly and reliable tools to effectively limit costs of RCTs through optimized budget planning and cost monitoring during the conduct of an RCT are currently unavailable and sorely needed. We therefore propose three complementary projects using mixed-methods to render investigator-initiated RCTs more affordable and efficient through evidence-based budget planning, stakeholder consensus regarding relevant budget items, and the development of suitable tools. In Project A we will gather empirical resource use and cost data from 180 investigator-initiated RCTs in Switzerland, Germany, Canada, and the United Kingdom to investigate cost patterns, empirically identify major cost drivers and lever-points for cost savings, examine planned versus actual RCT costs, and explore heterogeneity of costs across medical fields and countries. Project B will consist of semi-structured interviews to explore current practices, attitudes, needs, and preferences of trial investigators, trial funders, and trial support organizations with respect to budget planning, funding acquisition for RCTs, managing costs during RCT conduct, and supporting tools in Switzerland. In Project C we will develop reliable and user-friendly budget calculation and cost monitoring tools for RCTs with stakeholder consensus based on systematically collected evidence from the literature/internet and informed by user needs and preferences (as elicited in Project B). We will formally user-test and evaluate the reliability and accuracy of developed tools using the generated database of empirical RCT cost data from Project A. The results of the proposed mixed-methods work will have immediate impact on the research practice of trial investigators, trial support organizations, and funders of RCTs in Switzerland and abroad. Given the increasing costs and complexity of RCTs, our project is timely and should shift the discussion from "rough guesses" to "analysing transparent and valid data" so that costs of clinical trials can be assessed, cost drivers identified, and costs effectively limited so that RCTs, critical to advancing clinical science, become more affordable.

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When clinical research fails: a study of controlled trials that were discontinued

Research Project  | 1 Project Members

Clinical trials may be discontinued for different reasons, for example when it becomes apparent that a clinically relevant treatment effect will not be seen; when unanticipated adverse effects occur; or when outcomes are clearly superior in one study group. In addition, many trials are discontinued due to insufficient recruitment (slow accrual) of participants. This has ethical implications because participants consent on the premise of contributing to the advancement of medical knowledge, research ethics committees and funding agencies spend considerable resources on reviewing protocols of planned studies, and finite resources for research are wasted. Little is known about the epidemiology of discontinued trials in Switzerland. We propose to assemble a cohort of clinical trials based on protocols approved by research ethics committees in Lausanne, Basel, Lucerne, and Zurich between 2000 and 2004. We will explore other sources of trials, for example trials funded by the Swiss National Science Foundation. We will analyze this cohort to determine the risk of discontinuation of trials for different reasons. Using a case-control design, we will focus on trials that were discontinued due to insufficient recruitment. We will compare these trials with trials that were completed and thus identify characteristics of study protocols associated with discontinuation due to poor recruitment. Finally, we will examine the publication history of trials that were discontinued, and assess to what extent any lessons learned have been disseminated. We will extract relevant data from the files of the collaborating ethics committees and from published trial reports, and through a survey of trialists. The study will be based on over 1000 protocols of clinical trials, and about 150 trials that were discontinued due to poor recruitment. The proposed research is timely: recruitment of trial participants has repeatedly been identified as a serious ?bottleneck? in clinical research. The planning of effective recruitment strategies and anticipation of problems is a core task of the Clinical Trial Units (CTUs) that have been established in Switzerland with the support of SNSF. Our study will provide important insights into the problems with recruitment of participants that were encountered in randomized trials conducted in Switzerland in the recent past. It will identify modifiable barriers to successful study completion and inform future recommendations to individual trialists, research groups and units providing methodological support.