Bose Debdipta, Saha Shruti, Saxena Unnati, Kesari Harshad, Thatte Urmila M, Gogtay Nithya J
Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Perspect Clin Res. 2020 Apr-Jun;11(2):81-85. doi: 10.4103/picr.PICR_198_18. Epub 2020 May 6.
A key determinant of the success of any study is the recruitment and subsequent retention of participants. Screen failure and dropouts impact both the scientific validity and financial viability of any study. We carried out this audit with the objective of evaluating the recruitment and retention of participants in clinical studies conducted over the last five years at our center.
Studies completed between 2014 and 2018 at our center were included. Screening ledgers and study trackers were hand searched for screen failures and dropouts. Four pre-identified predictors were evaluated - risk as per the classification of Indian Council of Medical Research 2017 Ethical Guideline, nature of funding, study design, and nature of participants. Association of the predictors with screen failures and dropouts was determined using crude odds ratios along with 95% confidence intervals. All analyses were done at 5% significance using Microsoft Excel 2016.
A total of = 19 completed studies had = 2567 screened and = 2442 enrolled participants with a screen failure and dropout rate of 5% and 4%, respectively. We found 59% screen failures due to abnormal laboratory values. The main reasons for dropouts were lost to follow-up 86 (88%). High-risk and interventional studies were the predictors for both screen failures and dropouts, but pharmaceutical industry-funded studies and healthy participants were predictors for only screen failures.
Risk, funding, study design, and nature of participants are important to be considered while planning studies to minimize screen failures and dropouts.
任何研究成功的一个关键决定因素是参与者的招募及后续留存。筛选失败和退出研究对任何研究的科学有效性和财务可行性都会产生影响。我们开展此次审计的目的是评估过去五年在我们中心进行的临床研究中参与者的招募和留存情况。
纳入了2014年至2018年在我们中心完成的研究。人工查阅筛选台账和研究跟踪记录以查找筛选失败和退出研究的情况。评估了四个预先确定的预测指标指标——根据印度医学研究理事会2017年伦理指南分类的风险、资金性质、研究设计和参与者性质。使用粗比值比及95%置信区间确定这些指标与筛选失败和退出研究之间的关联。所有分析均使用Microsoft Excel 2016在5%的显著性水平下进行。
总共19项完成的研究中有2567人接受筛选,2442人登记参与研究,筛选失败率和退出率分别为5%和4%。我们发现59%的筛选失败是由于实验室值异常。退出研究的主要原因是失访,共86例(88%)。高风险和干预性研究是筛选失败和退出研究的预测因素,但制药行业资助的研究和健康参与者仅是筛选失败的预测因素。
在规划研究时,风险、资金、研究设计和参与者性质是需要考虑的重要因素,以尽量减少筛选失败和退出研究的情况。