Nelson Elizabeth, Shadbolt Cade, Bunzli Samantha, Cochrane Angela, Choong Peter, Dowsey Michelle
The University of Melbourne Department of Surgery, St. Vincent's Hospital, Level 2 Clinical Sciences Building, 29 Regent Street, Fitzroy, Melbourne, VIC, 3065, Australia.
Department of Orthopaedics, St. Vincent's Hospital, Level 3 Daly Wing, 35 Victoria Parade, Fitzroy, Melbourne, 3065, VIC, Australia.
Pilot Feasibility Stud. 2021 Feb 8;7(1):46. doi: 10.1186/s40814-021-00782-7.
Placebo-controlled surgical trials are recognised as the gold standard way to test the efficacy of a surgical procedure. Despite a rise in arthroscopic subacromial decompression (ASD) surgeries for the treatment of shoulder pain, only two placebo-controlled surgical trials have been conducted. These trials encountered significant recruitment challenges, threatening the external validity of findings. Difficulties with recruitment are common in clinical trials and likely to be amplified in placebo-controlled surgical trials. This mixed method feasibility trial aims to address the following questions: (i) Feasibility: What proportion of patients who have consented to undergo ASD report that they would be willing to enrol in a placebo-controlled trial for this procedure? (ii) Optimisation: Can patients' willingness to enrol in, or understanding of, such a trial be improved by supplementing written consent materials with a brief visual animation that outlines the details of the trial? And (iii) exploration: What factors influence patients stated willingness to enrol in such a trial, and how do they believe the recruitment process could be improved?
This study aims to recruit 80 patients on the waiting list for ASD. Participants will be randomised (1:1) to either view a brief video animation explaining the hypothetical placebo-controlled trial in addition to written information or to written information only. Participants in both groups will be required to state if they would be willing to opt-in to the hypothetical ASD trial after immediately being presented with the consent material and again 1 week after completion of the consent process. Patients in both groups will also be required to complete a measure of trial literacy. Twenty participants will be purposively sampled to take part in an embedded qualitative study exploring understanding of trial concepts and factors contributing to willingness to opt-in.
This feasibility study will provide evidence for optimising participant recruitment into a placebo-controlled trial of ASD by consenting patients using animated trial information in addition to written information. This pilot and feasibility data may also be relevant to placebo-controlled surgical trials more broadly, which are characterised by recruitment challenges.
ANZCTR, ACTRN12620001132932 , date October 30, 2020.
安慰剂对照的外科手术试验被认为是测试外科手术疗效的金标准方法。尽管用于治疗肩部疼痛的关节镜下肩峰下减压术(ASD)手术有所增加,但仅进行了两项安慰剂对照的外科手术试验。这些试验面临重大的招募挑战,威胁到研究结果的外部有效性。招募困难在临床试验中很常见,在安慰剂对照的外科手术试验中可能会加剧。这项混合方法可行性试验旨在解决以下问题:(i)可行性:同意接受ASD手术的患者中,有多大比例表示愿意参加该手术的安慰剂对照试验?(ii)优化:通过用简短的视觉动画补充书面同意材料来概述试验细节,能否提高患者参加或理解此类试验的意愿?以及(iii)探索:哪些因素影响患者表示愿意参加此类试验,以及他们认为招募过程如何可以改进?
本研究旨在招募80名在ASD等候名单上的患者。参与者将被随机分配(1:1),要么除了书面信息外还观看一段解释假设的安慰剂对照试验的简短视频动画,要么只观看书面信息。两组参与者都需要在立即收到同意材料后以及在同意过程完成1周后,表明他们是否愿意选择参加假设的ASD试验。两组患者还需要完成一项试验知识测试。将有目的地抽取20名参与者参加一项嵌入式定性研究,探讨对试验概念的理解以及促成选择参加意愿的因素。
这项可行性研究将为通过除书面信息外还使用动画试验信息让患者同意,来优化安慰剂对照的ASD试验的参与者招募提供证据。这些试点和可行性数据可能也更广泛地适用于安慰剂对照的外科手术试验,这些试验的特点是存在招募挑战。
澳大利亚和新西兰临床试验注册中心,ACTRN12620001132932,日期为2020年10月30日。