A new study in CMAJ revisits the "10/90 gap" by examining the recent track record of leading medical journals. The authors found that many conditions or diseases common internationally are underrepresented in randomized controlled trials (RCTs) published in leading medical journals.
The authors used the World Health Organization's 1999 list of the top 30 causes of global burden of disease and examined the randomized controlled trials published in 6 leading international general medical journals (including CMAJ) that same year. Rochon and colleagues determined that only 16% of the trials were highly relevant to international health.
In a related commentary, Jha and Lavery take a wider perspective, pointing out that RCTs are only one component of the research needed to improve population health in developing countries. For many diseases that affect the world's poor, the pressing issue is not to discover a cure, but to find the most effective means to deliver treatments that are already available.
p. 1673 Relation between randomized controlled trials published in leading general medical journals and the global burden of disease -- P.A. Rochon
p. 1687 Evidence for global health -- P. Jha, J.V. Lavery