Written by Jack Beecher, TrialJourney Data Analyst
“The Clinical Trials Landscape Project is derived from the proprietary database transformation that www.trialjourney.com is built on,” said Dr. Irfan Khan, CEO of Circuit Clinical. “Our goal with this project is to provide patients, providers, and healthcare administrators with new insights that will help them understand clinical research as a care option and inform choices in regards to it.” The landscape of clinical trials in Dallas is a relatively balanced one, with UT Southwestern establishing itself as the dominant player and Texas Oncology next in line.
Despite being ranked as the fifth-largest Designated Market Area (DMA) by Nielsen in 20173 and the seventh-most populated Combined Statistical Area (CSA) in the country4,5, Dallas is underperforming in the clinical trial industry. While, of course, more trials have been conducted in Dallas than many other U.S. cities, its population (7,847,110)5 suggests that its trial volume should be much higher based on that of other major cities. A total of 14,309 clinical trials have been conducted in the greater Dallas area, placing it well behind similarly-ranked CSAs such as Chicago (24,610 trials while ranked 3rd by Nielsen), Philadelphia (22,308 trials and ranked 4th by Nielsen), and San Jose (20,934 trials, ranked 6th by Nielsen)1,3. As seen in the map below, the greater Dallas area being referred to includes nearby cities such as Garland, Plano, Arlington, and Fort Worth while also extending to Granbury, Waxahachie, and as far north as Sherman and Denison.
Comparisons on the basis of population paint a similar picture for Dallas. The CSAs most immediately comparable in population to Dallas are Boston (with 8,233,270 residents) and Philadelphia (7,206,807), the 5th- and 7th-most populous in the country, respectively5. Despite having a population only about 400,000 greater than that of Dallas, a total 26,732 clinical trials have been conducted in Boston, a difference of more than 14,0001,5. Furthermore, Boston was ranked 9th of all U.S. DMAs by Nielsen3. Philadelphia, ranked 4th, has a population about 650,000 smaller than that of Dallas, yet boasts approximately 8,000 more trials than Dallas1,3,5.
The most active health system in Dallas is UT Southwestern, which had 865 active trials in 2018*, accounting for about 28.7% of active clinical trials in the area. The UT Southwestern Medical Center had 746 active trials last year alone, with its Simmons Cancer Center adding the remaining 119. Following UT Southwestern are Texas Oncology (587 active trials in 2018, about 19.4% of the Dallas total), Baylor Scott and White Health (339 active trials, 11.2%), Cook Children’s Health Care System (116 trials, 3.8%), and Children’s Health (92 trials, 3%). Other than the UT Southwestern facilities, locations that play prominent roles in the clinical trials landscape of Dallas include Texas Oncology at Baylor’s Sammons Cancer Center (147 active trials in 2018), Baylor University Medical Center (145 active trials), Cook Children’s Medical Center (112 trials), Children’s Medical Center Dallas (92 trials), Texas Oncology at Mary Crowley (76 trials), and Parkland Hospital (73 trials) among others1.
A theme of steady growth in trial volume is prevalent among most major metropolitan areas in the United States, and Dallas is no exception to this trend. Approximately 1,573 active clinical trials were conducted in the greater Dallas area in 2008; by 2018, this number practically doubled to 3,018. UT Southwestern Medical Center also came close to doubling over this span as well, going from 329 active trials in 2008 to 746 in 2018. Texas Oncology at the Sammons Cancer Center has also demonstrated significant growth, from 55 trials in 2008 to 147 in 2018, nearly tripling. In other notable instances of growth, the Baylor University Medical Center has grown from 87 trials to 145, Children’s Medical Center more than doubled from 41 to 92, Texas Oncology at Mary Crowley did the same from 32 to 76, Parkland Hospital grew from 27 to 73, and the Baylor Scott and White Heart Hospital in Plano grew from 5 to 47 trials, all from 2008 to 20181.
The alternative clinical trial sites in Dallas are mostly dominated by Texas Oncology, a network of cancer treatment sites across the entire state of Texas. This network boasts the two most active alternative trial locations in the greater Dallas area, its sites at the Sammons Cancer Center and Mary Crowley. However, there are still others that have also demonstrated notable growth. Following these two Texas Oncology sites are the Center for Cancer and Blood Disorders in Fort Worth (growing from 12 trials in 2008 to 52 last year), Texas Digestive Disease Consultants in Southlake (from two trials in 2011 to 43 in 2018), and Texas Oncology at the Fort Worth Cancer Center (from 25 trials in 2008 to 41 in 2018). In addition, the Texas Clinical Research Institute (a single active trial in 2009 to 36 in 2018) and the Metroplex Clinical Research Center (7 trials in 2008 to 33 in 2018) are other alternative sites seeing rapid growth in the clinical trials landscape of Dallas1.
More recent analyses of the TrialJourney database indicate that there are currently an estimated 3,586 active clinical trials in the Dallas CSA. Additionally, 1,900 (53%) of these trials are currently recruiting for participation. A total of 999 (or, 27.9%) of the currently active trials in Dallas are being conducted by UT Southwestern, and an estimated 581 (58.2% of its total) of these are recruiting. This health system also comprises 30.6% of all recruiting trials in Dallas. The UT Southwestern Medical Center alone currently has 741 active trials (456, or 61.5%) of them recruiting), accounting for 74.1% of UT Southwestern’s active trials and 78.5% of the system’s recruiting trials as well as 20.7% and 24% of active and recruiting trials in all of Dallas alone, respectively. Texas Oncology has a current total of 719 active trials (266, or 37%, recruiting), comprising 20% of active trials and 14% of recruiting trials in Dallas. Baylor Scott and White Health currently has 365 active trials; 214 (58.6%) of these trials are recruiting, and the system accounts for about 10.2% of active trials in Dallas and 11.3% of its recruiting trials. Finally, Cook Children’s Health System has 140 active trials, making up 3.9% of them in Dallas. A total of 85 (60.7%) of these trials are recruiting, contributing 4.5% of such trials in the CSA2.**
Dallas is clearly one of the largest metropolitan areas in the entire country, but its clinical trial volume shows room for growth when considering market size. Cities with somewhat similar populations boast significantly more research than Dallas does. However, this means that the greater Dallas area is primed for acceleration in the field, and it is still a significant contributor to the overall landscape of the country.
*Active in 2018 = Active at any point in 2018 (Start date of study is before 12/31/2018 and end date is after 1/1/2018)
**As part of our ongoing quality assurance process, we've enhanced and improved our trial accounting algorithm in order to capture clinical trials with inconclusive and/or unstated completion dates.