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临床试验中患者报告结局(PRO)数据收集的当前实践:对英国试验工作人员和管理人员的横断面调查。

Current practices in patient-reported outcome (PRO) data collection in clinical trials: a cross-sectional survey of UK trial staff and management.

作者信息

Kyte Derek, Ives Jonathan, Draper Heather, Calvert Melanie

机构信息

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

School of Social and Community Medicine, University of Bristol, Bristol, UK.

出版信息

BMJ Open. 2016 Oct 3;6(10):e012281. doi: 10.1136/bmjopen-2016-012281.

Abstract

OBJECTIVES

Patient-reported outcome measures (PROMs) collected in clinical trials should be administered in a standardised way across sites and routinely screened for avoidable missing data in order to maximise data quality/minimise risk of bias. Recent qualitative findings, however, have raised concerns about the consistency of PROM administration in UK trials. The purpose of this study was to determine the generalisability of these findings across the wider community of trial personnel.

DESIGN

Online cross-sectional survey.

SETTING

Participants were recruited from 55 UK Clinical Research Collaboration Registered Clinical Trials Units and 19 Comprehensive Local Research Networks.

PARTICIPANTS

Research nurses, data managers/coordinators, trial managers and chief/principal investigators involved in clinical trials collecting PROMs.

ANALYSIS

We undertook descriptive analyses of the quantitative data and directed thematic analysis of free-text comments. Factors associated with the management of missing PRO data were explored using logistic regression.

RESULTS

Survey data from 767 respondents supported the generalisability of qualitative study findings, suggesting inconsistencies in PROM administration with regard to: the level of assistance given to trial participants; the timing of PROM completion in relation to the clinical consultation; and the management of missing data. Having ≥10 years experience in a research role was significantly associated with the appropriate management of missing PROM data (OR 2.26 (95% CI 1.06 to 4.82), p=0.035). There was a consensus that more PROM guidance was needed in future trials and agreement between professional groups about the necessary components.

CONCLUSIONS

There are inconsistencies in the way PROMs are administered by trial staff. Such inconsistencies may reduce the quality of data and have the potential to introduce bias. There is a need for improved guidance in future trials that support trial personnel in conducting optimal PROM data collection to inform patient care.

摘要

目的

临床试验中收集的患者报告结局指标(PROMs)应以标准化方式在各研究点进行管理,并定期筛查可避免的缺失数据,以最大限度提高数据质量/最小化偏倚风险。然而,近期的定性研究结果引发了对英国试验中PROM管理一致性的担忧。本研究的目的是确定这些结果在更广泛的试验人员群体中的普遍性。

设计

在线横断面调查。

背景

参与者从55个英国临床研究协作注册临床试验单位和19个综合地方研究网络中招募。

参与者

参与收集PROMs的临床试验的研究护士、数据管理员/协调员、试验经理以及首席/主要研究者。

分析

我们对定量数据进行了描述性分析,并对自由文本评论进行了定向主题分析。使用逻辑回归探讨了与缺失PRO数据管理相关的因素。

结果

来自767名受访者的调查数据支持了定性研究结果的普遍性,表明在PROM管理方面存在不一致之处,包括:给予试验参与者的协助水平;PROM完成时间与临床咨询的关系;以及缺失数据的管理。在研究岗位上有≥10年经验与正确管理缺失的PROM数据显著相关(比值比2.26(95%置信区间1.06至4.82),p = 0.035)。大家一致认为,未来的试验需要更多的PROM指南,并且专业团体之间就必要组成部分达成了共识。

结论

试验人员管理PROM的方式存在不一致之处。这种不一致可能会降低数据质量,并有可能引入偏倚。未来的试验需要改进指南,以支持试验人员进行最佳的PROM数据收集,为患者护理提供依据。

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本文引用的文献

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Management of Patient-Reported Outcome (PRO) Alerts in Clinical Trials: A Cross Sectional Survey.
PLoS One. 2016 Jan 19;11(1):e0144658. doi: 10.1371/journal.pone.0144658. eCollection 2016.
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