Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.
John Goligher Colorectal Unit, St. James's University Hospital, Leeds, UK.
J Clin Epidemiol. 2021 May;133:94-100. doi: 10.1016/j.jclinepi.2021.01.002. Epub 2021 Jan 21.
To explore the approach to participant coenrolment in publicly funded randomized controlled trials (RCTs) and to consider its impact on study recruitment.
A cross-sectional study of the UK National Institute for Health Research Journals Library was undertaken. RCTs funded between 2010 and 2019 were eligible. The reporting of coenrolment criteria was assessed through inspection of publicly available study protocols. Where present, the approach to coenrolment was examined, including circumstances in which it was permitted/prohibited and the mechanism for decision-making. For completed RCTs, the impact on recruitment was explored by comparing rates of early recruitment (completion before the expected end date) and extensions (completion after the expected end date) between studies, which did and did not permit coenrolment.
Of 219 eligible protocols, coenrolment was addressed in 94 (42.9%). Twenty-three (24.5%) of these did not allow recruitment to multiple studies, while 71 (75.5%) permitted it according to a series of caveats, including considerations of study outcomes, intervention type, and patient burden. The final decision for coenrolment rested with the local recruitment team in 57 (60.6%) and with the central organizing team in 37 (39.4%). Early completion of recruitment occurred in 8 of 64 (12.5%) RCTs where coenrolment was permitted and 5 of 20 (25.0%) where it was not (P = 0.285). An extension to recruitment time was required in 31 of 64 (48.4%) RCTs where coenrolment was permitted and 9 of 11 (45.0%) where it was not (P = 0.788).
The reporting of coenrolment in protocols of publicly funded RCTs is infrequent, and where present, the approach to decision-making is widely variable. In this study, policies of coenrolment were not associated with gains in trial recruitment.
探索在公开资助的随机对照试验(RCT)中纳入参与者的方法,并考虑其对研究招募的影响。
对英国国家卫生研究院期刊库进行了一项横断面研究。符合条件的 RCT 为 2010 年至 2019 年期间资助的 RCT。通过检查公开提供的研究方案评估共同纳入标准的报告情况。如果存在,检查共同纳入的方法,包括允许/禁止的情况以及决策机制。对于已完成的 RCT,通过比较允许/不允许共同纳入的研究的早期招募(在预期结束日期前完成)和扩展(在预期结束日期后完成)的比例来探索对招募的影响。
在 219 项符合条件的方案中,94 项(42.9%)涉及共同纳入。其中 23 项(24.5%)不允许同时招募多项研究,而 71 项(75.5%)根据一系列注意事项允许,包括研究结果、干预类型和患者负担的考虑。57 项(60.6%)由当地招募团队和 37 项(39.4%)由中央组织团队决定最终是否共同纳入。在允许共同纳入的 64 项 RCT 中,有 8 项(12.5%)提前完成招募,而在不允许共同纳入的 20 项 RCT 中,有 5 项(25.0%)提前完成(P=0.285)。允许共同纳入的 64 项 RCT 中有 31 项(48.4%)需要延长招募时间,而不允许共同纳入的 11 项 RCT 中有 9 项(45.0%)需要延长(P=0.788)。
方案中共同纳入的报告很少,并且在存在的情况下,决策方法也存在广泛的差异。在这项研究中,共同纳入政策并没有增加试验的招募。