Pandemic effects? The 2020 NHMRC Clinical Trials and Cohort Studies

Updated: Oct 15, 2021

Last year’s funded clinical trials and cohort studies were a special batch, but not because they studied Covid...

The NHMRC has just called for 2021 proposals for clinical trials and cohort studies. If you’re interested in applying for these extremely competitive grants, you might want to see what has been successful already. So let’s take a look!

A tough competition

The ‘CTCS’ grants are still quite new, and their early life has been turbulent. The first round (in 2019) was very popular, with nearly 600 proposals. But we saw an astonishingly low 5.4% funded, as the $75 million funding only stretched so far. This abysmal rate may have led to application hesitancy in 2020.

Then last year’s second round was unusual in a different way with the pandemic arriving just as many were about to write their applications. So the NHMRC extended the deadline nearly seven months (from 29 Apr to 25 Nov) to relieve pressure in March and April. Despite the delay, researchers still proposed 24% fewer applications in total – meaning the (unchanged $75 million) NHMRC funding now extended to 6.9% of the 2020 proposals. If applications were to drop again in 2021’s third round now open (trendline suggests 300), we might make it to the dizzying heights of 10%!

Unusual 2020 patterns

If we look closely, we can see that Victorian-led applications were particularly low in 2020 (down 38%), as Melbourne’s long second lock-down lasted through much of the extended application time. Yet nearly half (47%) of the trials and studies funded were Victorian-led, which is disproportionately high since they only accounted for 1/3 of applications.

At the time, many wondered if lockdowns would also cause a gendered effect on applications. For CTCS grants however, applications from female lead researchers (‘chief investigator A’, CIA) remained unchanged at 40%, perhaps due to the extra time for applications. Curiously however, 60% of the funded 2020 trials/studies had a female CIA, meaning proposals with a female CIA were about twice as successful as those with a male CIA:

What’s going on here? I would wager that those most affected by 2020 made the time to apply only when their proposals were very strong, well developed, and well suited to CTCS funding. It would be interesting to see if there was any difference in proposal scores this year, though the NHMRC does not usually release that detail.

Another noticeably high 2020 success rate (at 16.2%) was for Public Health trials/studies. This rate resulted from 37 % of the grants being awarded to Public Health proposals, despite them only making up 15% of the applications:

This disproportionate funding is unusual, and the NHMRC will often use ‘structural funding’ to even out success rates for the four ‘broad research areas’. Obviously we wouldn’t expect much basic science, but why have the other three diverged? Are Public Health proposals somehow inherently more suited to the CTCS scheme? Do they score well against the selection criteria? Or could this be another 2020 anomaly – that the pandemic raised the profile of public health more generally?

In contrast, Aboriginal and Torres Strait Islander trials and studies seem to have faired poorly in 2020. More trials were proposed, but fewer were successful:

Perhaps we need to bring back grant review panels – another casualty of 2020 – to help fund this valuable research.

Types of trial / study

Let’s dig a little further, into what types of investigation were funded. As in 2019, 2020 saw a 7:3 split between awarded clinical trials and cohort studies, roughly equal to the overall proportion of applications:

In both years, the funded cohort studies were roughly evenly split between prospective and retrospective studies, with data linkage clearly involved in several. The clinical trials were a mix of interventions for treatment/therapy, prevention, and some diagnostic/prognostic/screening interventions. Rehabilitation, behavioural and surgical interventions were rare. A couple of trials each year were clearly phase III and several more declared follow-ups/additions to ongoing trials. However more than half appear to be first ever investigations, which may work well against the official CTCS objective to ‘address important gaps in knowledge’. Indeed, many explicitly identified the core evidence problem in their summaries.

A wide range of research questions have been funded (31 different primary filed of research areas as defined by applicant). Psychology and cognitive science fields of research remained a minority (2/31). But 2020 may have seen a slight bump in psychiatry and epidemiology, and (perhaps surprisingly) a dip in infectious diseases:

However, none of those ‘infectious diseases’ include Covid-19. Neither did the ‘respiratory diseases’. In fact, not a single trial or study in 2020 addressed the pandemic nor any consequences of it. Despite being submitted in 2020! Then again, by deadline day (25 November 2020), many may have felt that the worst of the pandemic was over. Successful vaccines had already been announced, and countries appeared to have successfully brought infections under control. Many trials for vaccine or therapy were of course underway (if not completed) already, and the CTCS funding mechanism (with results mid-2021) may just have appeared too slow, with trials/studies not starting till late 2021. Many Covid-related trials and studies were instead submitted through MRFF calls earlier in the year.

Reading the published grant summaries, one gets a sense of just how much important work must still be funded in addition to Covid, how dismally $75 million compares to this – now incredulously reduced to $70 million – and how many more great ideas must be sitting just beyond the funding line. So if you’re cooking up a proposal of a new clinical trial or cohort study, please get in touch, as we’d love to help you get that great work funded! Email us at for more information on our services. We are happy to send you a brochure or arrange a time to talk through your options.