My name is Neil Ranasinghe, I am a Patient Advocate from London. I recently attended the CReDO workshop in India. This is the first of three articles describing the workshop and how it is increasing research capacity.
There is a huge amount of research into cancer being done in high income countries (HIC), but for many reasons, and hardly surprisingly, there is considerably less research being done in low- and middle-income countries (LMIC). As a result, research, protocols, treatment, patient care etc is being adapted for patients in LMIC rather than designed for patients in LMIC.
This means it isn’t as effective, not feasible given the available resources and infrastructure limitations. In some cases it is dangerous to implement in low resource settings due to risk of individual patient experiencing toxicity as well as huge opportunity cost. This reliance on research done in HIC is bad for patients.
There is a lack of clinicians who are appropriately trained in research methods, and due to high patient volumes per clinician, very limited time available that is only for research purposes. These are important reasons for poor research outputs from LMICs, and it results in adopting treatment based on research done in HIC.
Annual workshop
A particularly effective and visionary organisation in India called the National Cancer Grid is doing something about this. They run an annual workshop called Collaboration for Research Methods Development in Oncology (CReDO) to increase the research capacity across India and other LMICs. The workshops help participants transform a great research idea into a finished protocol by the end of the week. It is then presented to an ethics board for approval and implemented at the hospital/institution they work.
There were about 70 participants, most were doctors, and the majority came from India, but there were strong contingents from Africa and Latin America. The faculty of highly esteemed and world-leading experts included doctors, epidemiologists, statisticians, nurses, paediatric oncologists, medical oncologists, surgeons, clinical trial experts, patient advocates. Faculty and participants were divided into eight groups for the week.
CReDO workshop participants in action
For some of us each day started with an exercise boot camp, yoga session or a run. I wanted to do all three! This was followed by a breakfast meeting at 8 am between mentors to check on how the participants were progressing, and if anything needs to be done differently.
There are lectures for participants every morning on aspects of clinical trial design, global health, statistics, research methods and other related topics. I attended many of these as I am interested in these areas.
Informative and amusing presentation from Professor Allan Hackshaw “Time-to- event analysis”
As if by magic
After lunch was when the real magic happened. For a few hours every afternoon, faculty and participants worked in their groups to go through their protocols. There are often radical changes at the beginning of the week, and then there is fine tuning later on. Statistics are drilled into, ethics are carefully considered, and perhaps above all, there is a lot of debate about the practicality, feasibility and impact of the research.
A key aim was to make participants think how does it affect patients, would patients want it, how feasible is this, and should the finite resources be used on this research?
A typical day at CReDO – but don’t forget yoga or exercise boot camp at 6.30 am.
Good evening
There were some activities in the evenings including team building, colour festival, and a poolside dinner to let their hair down (of course not mine) yet allow the participants to discuss their doubts about protocols.
Towards the end of the week, I was helping participants with their presentations. Very long but immensely enjoyable and rewarding days. It was rare that I would get back to my room before 10 pm.
Patient advocacy
Alongside the attendees learning how to write a protocol, there are also about 10 patient advocates being trained. Meaningful patient advocacy is growing in India but there aren’t enough patient advocates, and some clinicians are not yet welcoming of the patient voice. Putting the advocates with clinicians allows them to listen to each other and learn to involve the most important stakeholder in research – the patient!
What did I do?
I was there to help ensure protocols were patient-centered. Are the research and outcomes designed around patient needs and requests? In practical terms it is asking how many injections, how many visits to hospitals, when are these visits, what are the side effects, if there is a survey are all the questions necessary and do they make sense, can the lay summary be understood by the patient? This is the sort of thing I have been doing for 20 years for paediatric oncology clinical trials in the UK. I was also there to guide and assist the patient advocates that were learning the ropes. This was a pleasure as they were well informed, quick and enthusiastic learners.
Group H paying close attention to Dr Mini Devedas!
What happens next?
The participants leave with a much better understanding of ethics, statistics, trial design, trial implementation. Their network has increased massively across different disciplines, across India and across the world. They had countless meaningful interactions with faculty that often continues even after they have returned home. They are ready to implement their research, and this is exactly what they do.
Thank you
Thank you to CReDO for inviting me there for the second time. Thank you to all the participants for being so enthusiastic. Thank you to all of faculty for being so patient and approachable. Thank you to Dr Manju Sengar for providing invaluable help with this article. Thank you to my colleague, friend, Julie Waxgiser for dramatically improving yet another article of mine. Thank you to the London Stock Exchange Group for supporting me. Thank you to OncoDaily for publishing this. Look out for two more articles on CReDO 2026.
Here are my reflections from attending CReDO last year – How to train oncologists and researchers in clinical trial design in 6 days: CReDO 2025
Written by Neil Ranasinghe