Who funds stroke trials in Europe? A survey of funding sources for randomised controlled stroke trials by the European Stroke Organisation Trials Alliance (ESOTA) network

Abstract Aims and scope Evidence from randomised controlled trials (RCTs) has transformed stroke care. There are no systematically collected data on the amount of public funding, critical to delivering trials, going into stroke RCTs. To understand the extent of stroke RCT funding by national and EU funding bodies across Europe, the European Stroke Organisation Trials Alliance (ESOTA) conducted a survey of its member nations. Methods This is an observational study of research funding in Europe. The ESOTA steering group sent an electronic survey to the leads of the 16 participating national networks from 14 countries. Structured survey questions included who the funding bodies were in each country, the number of RCT applications put forward for public national or EU funding, the number of successful and failed applications, and the amount of funding granted between 01/01/2022 and 31/12/2023. Results Responses were received from 13 of 14 participating countries. There was significant variation in the number of grant applications submitted by individual countries, ranging from 0-17 during the 24-month survey period. The median number of funded studies per country was 1 (IQR 3, range 0-9) representing a median success rate of 47.1 % (IQR 21.1-59.4%), with no RCTs granted joint European funding. Conclusions Our survey highlights significant inequities in stroke trial funding across Europe. Given the encouraging rate of successful applications overall, it is important for all member networks to submit proposals. This is particularly pertinent for multicentre trials, given the evolution of evidence base in stroke towards large trials, across diverse populations.