Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, North Carolina, United States of America.
Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, United States of America.
PLoS One. 2022 May 4;17(5):e0267974. doi: 10.1371/journal.pone.0267974. eCollection 2022.
In order to study the role of the microbiome in hematopoietic stem cell transplantation (HCT), researchers collect stool samples from patients at various time points throughout HCT. However, stool collection requires active subject participation and may be limited by patient reluctance to handling stool.
We performed a prospective study on the impact of financial incentives on stool collection rates. The intervention group consisted of allogeneic HCT patients from 05/2017-05/2018 who were compensated with a $10 gas gift card for each stool sample. The intervention group was compared to a historical control group of allogeneic HCT patients from 11/2016-05/2017 who provided stool samples before the incentive was implemented. To control for possible changes in collections over time, we also compared a contemporaneous control group of autologous HCT patients from 05/2017-05/2018 with a historical control group of autologous HCT patients from 11/2016-05/2017; neither autologous HCT group was compensated. The collection rate was defined as the number of samples provided divided by the number of time points we attempted to obtain stool.
There were 35 allogeneic HCT patients in the intervention group, 19 allogeneic HCT patients in the historical control group, 142 autologous HCT patients in the contemporaneous control group (that did not receive a financial incentive), and 75 autologous HCT patients in the historical control group. Allogeneic HCT patients in the intervention group had significantly higher average overall collection rates when compared to the historical control group allogeneic HCT patients (80% vs 37%, p<0.0001). There were no significant differences in overall average collection rates between the autologous HCT patients in the contemporaneous control and historical control groups (36% vs 32%, p = 0.2760).
Our results demonstrate that a modest incentive can significantly increase collection rates. These results may help to inform the design of future studies involving stool collection.
为了研究微生物组在造血干细胞移植（HCT）中的作用，研究人员在 HCT 过程中的各个时间点从患者收集粪便样本。然而，粪便采集需要患者的积极参与，并且可能因患者不愿处理粪便而受到限制。
我们进行了一项关于经济激励对粪便采集率影响的前瞻性研究。干预组由 2017 年 5 月至 2018 年 5 月期间接受异基因 HCT 的患者组成，每位患者每提供一份粪便样本可获得 10 美元的加油卡作为补偿。干预组与在实施激励措施之前提供粪便样本的 2016 年 11 月至 2017 年 5 月期间接受异基因 HCT 的历史对照组进行比较。为了控制随时间采集量可能发生的变化，我们还将 2017 年 5 月至 2018 年 5 月期间接受自体 HCT 的同期对照组与 2016 年 11 月至 2017 年 5 月期间接受自体 HCT 的历史对照组进行比较；两个自体 HCT 组均未获得补偿。采集率定义为提供的样本数除以我们尝试采集粪便的时间点数。
干预组有 35 例异基因 HCT 患者，历史对照组有 19 例异基因 HCT 患者，同期对照组（未获得经济激励）有 142 例自体 HCT 患者，历史对照组有 75 例自体 HCT 患者。与历史对照组的异基因 HCT 患者相比，干预组的异基因 HCT 患者的总体平均采集率显著更高（80%比 37%，p<0.0001）。同期对照组和历史对照组的自体 HCT 患者的总体平均采集率无显著差异（36%比 32%，p = 0.2760）。
我们的结果表明，适度的激励可以显著提高采集率。这些结果可能有助于为未来涉及粪便采集的研究设计提供信息。
