Trials and tribulations of multicenter studies

Multicenter studies in Pediatric Nephrology have been acknowledged in recent years as an important mechanism for studying renal disease in children. The purpose of this review is to describe some of the experiences of the Southwest Pediatric Nephrology Study Group (SPNSG) in order to assist others in developing their own multicenter studies. The importance of protocol development, including adequate attention to study design, data management, and data analysis, is emphasized. Mechanisms for facilitating the frequency and productivity of study group meetings that are so essential for the success of multicenter studies, are described in some detail. The need and some of the methods for achieving ongoing collaboration within a climate of critical peer review are also discussed. Controversial issues such as authorship and the question of institutional credit for involvement in multicenter studies are discussed in brief. Finally, some of the features of the SPNSG that have permitted us to meintain a relatively high rate of productivity are described. The two most important of these, ongoing commitment to the group and willingness to collaborate across differences of opinion, are stressed throughout the review.SPNSG centers Baylor College of Medicine, Houston, Tex.; Baylor University Medical Center, Dallas, Tex.; Cook-Fort Worth Children's Medical Center, Fort Worth, Tex., Louisiana State University, New Orleans, La.; Texas A and M University, Temple, Tex.; Tulane University Medical Center, New Orleans, La.; University of Alabama at Birmingham, Birmingham, Ala.; University of Arkansas, Little Rock, Ark.; University of Colorado, Denver, Colo.; Oklahoma University Health Science Center, Oklahoma City, Okla.; University of Tennessee, Memphis, Tenn.; University of Texas Health Science Center, San Antonio, Tex.; University of Texas Medical Branch, Galveston, Tex.; University of Texas Medical School, Houston, Tex.; University of Texas Southwestern Medical Center, Dallas, Tex.; University of Utah, Salt$Lake City, Utah