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从OCTET研究中学习——探索临床试验管理方法的可接受性。

Learning from OCTET - exploring the acceptability of clinical trials management methods.

作者信息

Arundel Catherine, Gellatly Judith

机构信息

Department of Health Sciences, University of York, York, UK.

Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.

出版信息

Trials. 2018 Jul 13;19(1):378. doi: 10.1186/s13063-018-2765-6.

Abstract

BACKGROUND

Conducting research can be time consuming, difficult and challenging. Guidance and pragmatic advice focussing on randomised controlled trial conduct are available but do not necessarily constitute comprehensive guidance. A successful trial is one that recruits to time and target and collects high-quality data within the originally agreed budget. Standardised trial management tools have outlined key project management elements for a successful trial as a method of ensuring good practice in research trials: initiation, planning, execution, monitoring and closure. Lessons are also frequently learnt during the development and conduct of trials but rarely shared for the benefit of others. For the wider research team, the key focus will always be on the execution and delivery of a study. The aim of this study was to evaluate the acceptability of clinical trials management methods, focussing on study execution and monitoring, as implemented in the National Institute for Health Research Health Technology Assessment Programme-funded Obsessive Compulsive Treatment Efficacy Trial (OCTET).

METHODS

Workshops, questionnaires and semi-structured interviews were used to explore acceptability of trial management methods with members of the OCTET Trial research team. Nine members participated in the focus group, 10 completed a questionnaire and 20 were interviewed as part of qualitative work for the main OCTET study. Data was collected and analysed using thematic analysis.

RESULTS

Six key themes were identified: support; communication; processes; resources; training and ethos. Clear and open communication, enthusiasm and accessibility of the trial managers and chief investigator were consistently noted as an important facet of the successful running of the trial. Clear resources and training materials were also found to be crucial in helping staff to work within the trial setting. Constructive suggestions were also made for improvement of these resources; for example, including both checklists and flowcharts within trial processes.

CONCLUSION

Organisation, openness and positivity are crucial for executing a trial successfully, whilst clear and focussed processes and resources are essential in monitoring and controlling the trial progress. Although derived from a single study, these findings are likely to be applicable to the successful conduct of all trials. Trial managers should consider developing these elements when setting up a study.

TRIAL REGISTRATION

Clinical Trial Registry, ID: ISRCTN73535163 . Registered prospectively on 5 April 2011.

摘要

背景

开展研究可能耗时、困难且具有挑战性。虽有侧重于随机对照试验实施的指导和实用建议,但不一定构成全面指导。成功的试验是指按时并按目标招募受试者,并在最初商定的预算内收集高质量数据。标准化的试验管理工具已概述了成功试验的关键项目管理要素,作为确保研究试验良好实践的一种方法:启动、规划、执行、监测和结束。在试验的开发和实施过程中也经常会吸取经验教训,但很少为他人的利益而分享。对于更广泛的研究团队而言,关键重点始终是研究的执行和交付。本研究的目的是评估在英国国家卫生研究院卫生技术评估计划资助的强迫症治疗疗效试验(OCTET)中实施的临床试验管理方法的可接受性,重点是研究执行和监测。

方法

采用研讨会、问卷调查和半结构化访谈来探讨OCTET试验研究团队成员对试验管理方法的可接受性。9名成员参加了焦点小组,10人完成了问卷调查,20人作为OCTET主要研究定性工作的一部分接受了访谈。使用主题分析法收集和分析数据。

结果

确定了六个关键主题:支持;沟通;流程;资源;培训和风气。试验管理人员和首席研究员清晰、开放的沟通、热情和易接近性一直被视为试验成功开展的一个重要方面。还发现明确的资源和培训材料对于帮助工作人员在试验环境中工作至关重要。也有人针对这些资源的改进提出了建设性建议;例如,在试验流程中同时纳入检查表和流程图。

结论

组织、开放和积极态度对于成功执行试验至关重要,而清晰且重点突出的流程和资源对于监测和控制试验进展至关重要。尽管这些发现源自一项单一研究,但可能适用于所有试验的成功开展。试验管理人员在开展一项研究时应考虑发展这些要素。

试验注册

临床试验注册库,编号:ISRCTN73535163。于2011年4月5日前瞻性注册。

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