Introducing the Clinical Trials Abundance blog

Ideas, thoughts and commentary about clinical trials and how to make them more efficient by Saloni Dattani, Adam Kroetsch, Manjari Narayan, Ruxandra Teslo, and Witold Więcek.

Welcome to the Clinical Trials Abundance blog! This is a joint blog where we’ll post ideas, thoughts and commentary about clinical trials and how to make them more efficient.

Clinical trials are how new drugs are tested before becoming widely available. In most countries, like the US and UK, where we live, trials are expensive and slow. Effective drugs can be stuck in clinical trials for years, sometimes a decade or more, before the results are clear and those drugs are available to patients who need them. Clinical trials are also generally treated as a high-stakes, one-shot test to produce a final binary decision on whether a drug works, rather than as part of an ongoing evidence loop that could help accelerate innovation.

We think things could be different. Clinical trials could run more efficiently through modular components, innovative trial design, streamlined ethical approval, faster recruitment, and many other improvements. They could collect more informative data to help discover new, effective biomarkers, not just confirm older ones. And by sharing the data from them, they could help improve drugs in the future too. All of this could allow us to test more drugs in parallel and find out what works (or doesn’t) faster.

Despite major advances in AI, we believe that testing in humans – not just in animals or simulations – will remain essential for understanding effects in complex biological systems like humans, and effects that may vary between individuals and produce unexpected side effects.

Each of us – Adam, Manjari, Ruxandra, Saloni, and Witold – has been writing about these ideas on and off for years. We’ve started this blog because we want to have a common platform where we can publish more frequently, respond to news and policy change, share thoughts and start discussions, and seed ideas that can be refined and explored further.

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Here’s a short introduction to each of us:

Saloni Dattani is interested in accelerating medical innovation and scaling up efforts in global health. She’s previously written about why randomized controlled trials matter, why it took 141 years to develop a malaria vaccine, a prediction of why we’d get Covid vaccines in a year, and some ideas we can take from pandemic clinical trials to speed up innovation more broadly.

She works full time at Works in Progress magazine as an editor and writer, advises Coefficient Giving on clinical trial reform, and hosts the podcast Hard Drugs with Jacob Trefethen. Previously, she was a researcher at Our World in Data on global health and medicine, and holds a PhD in psychiatric genetics from King’s College London and the University of Hong Kong.

Adam Kroetsch is interested in system-level reforms to make trials more abundant. Through the Clinical Trials Efficiency Project, he is exploring how we can make trials faster and cheaper through better policies, regulations, incentives, and infrastructure. He has written about why trials are so expensive and what clinical trial abundance might look like. He has also written about the FDA’s history and how the FDA evaluates clinical trial evidence.

Adam publishes his work on his Substack, Policy and Practice. Previously, he worked at the FDA and the Duke-Margolis Institute for Health Policy. He holds a Masters in Public Policy and Management from Carnegie Mellon University.

Manjari Narayan is interested in accelerating methodological falsification in science. As a BRAINS fellow at Speculative Technologies she explored an ambitious program to improve preclinical forecasting evaluations in drug development. Manjari writes about biomarkers, neuroimaging, and statistics at Neurostats. She runs the Surrogate Science Project, a new community effort to bring the formal logic of good proxy development from biostatistics, econometrics and machine learning to all fields.

As a consultant, she advises biotech startups on early biomarker R&D, and collaborates with tech companies to improve scientific causal reasoning of AI agents. As a member of industry working groups in pharmaceutical statistics, she seeks to bring statistical rigor to earlier stages of biomarker development. She is a sought after invited speaker in several areas of biomedical research including multi-modal brain stimulation, psychiatric neuroimaging biomarkers, theoretical metascience, and statistical innovation in biopharma. Manjari’s early academic research focused on signal processing and nonparametric decision theory. Her subsequent graduate and postdoctoral work blended causal machine learning with biostatistics to understand and intervene on complex systems found in biology and medicine. She advanced uncertainty quantification and decision science for gene therapy at Dyno Therapeutics. She holds a PhD in Electrical Engineering from Rice University; her graduate work received the ENAR distinguished paper award in Biostatistics.

Ruxandra Teslo is interested in how we can reverse Eroom’s Law – the observation that pharmaceutical R&D efficiency declined, despite staggering advances in basic science. Convinced that making clinical trials more efficient would play a key role, she started the Clinical Trial Abundance Initiative, a policy effort focused on clinical trials at the Institute for Progress (IFP) in 2024. She has also written extensively about fertility and biomedical progress more broadly.

She is now a Fellow at Renaissance Philanthropy, where she continues to work on Clinical Trial Abundance. Her focus at the moment is on streamlining Phase I trials, FDA transparency and Drug Development Tools (DDTs). You can read her policy work on the IFP website. She holds a PhD in Genomics from Sanger Institute, University of Cambridge.

Witold Więcek is a statistician working on problems in global health, epidemiology, and development economics. Witold’s current research revolves around making vaccines more efficient, meta-analysis, low-cost life-saving interventions, and metascience.

Witold is a Consulting Director at Development Innovation Lab at University of Chicago, where he works on designing randomised controlled trials, a Senior Fellow at the Institute for Progress and a Research Fellow at the Center for Global Development. Previously he spent over a decade working as a consultant in the pharmaceutical industry. His PhD was on Bayesian approaches in biostatistics.

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We hope you enjoy reading!

– Saloni, Adam, Manjari, Ruxandra and Witold