Preston Nancy J, Farquhar Morag C, Walshe Catherine E, Stevinson Clare, Ewing Gail, Calman Lynn A, Burden Sorrel, Brown Wilson Christine, Hopkinson Jane B, Todd Chris
Lancaster University, International Observatory on End of Life Care, Furness College, Lancaster, UK, LA1 4YG.
University of Cambridge, Public Health & Primary Care, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, Cambridgeshire, UK, CB2 0SR.
Cochrane Database Syst Rev. 2016 Feb 29;2(2):MR000036. doi: 10.1002/14651858.MR000036.pub2.
Identifying and approaching eligible participants for recruitment to research studies usually relies on healthcare professionals. This process is sometimes hampered by deliberate or inadvertent gatekeeping that can introduce bias into patient selection.
Our primary objective was to identify and assess the effect of strategies designed to help healthcare professionals to recruit participants to research studies.
We performed searches on 5 January 2015 in the following electronic databases: Cochrane Methodology Register, CENTRAL, MEDLINE, EMBASE, CINAHL, British Nursing Index, PsycINFO, ASSIA and Web of Science (SSCI, SCI-EXPANDED) from 1985 onwards. We checked the reference lists of all included studies and relevant review articles and did citation tracking through Web of Science for all included studies.
We selected all studies that evaluated a strategy to identify and recruit participants for research via healthcare professionals and provided pre-post comparison data on recruitment rates.
Two review authors independently screened search results for potential eligibility, read full papers, applied the selection criteria and extracted data. We calculated risk ratios for each study to indicate the effect of each strategy.
Eleven studies met our eligibility criteria and all were at medium or high risk of bias. Only five studies gave the total number of participants (totalling 7372 participants). Three studies used a randomised design, with the others using pre-post comparisons. Several different strategies were investigated. Four studies examined the impact of additional visits or information for the study site, with no increases in recruitment demonstrated. Increased recruitment rates were reported in two studies that used a dedicated clinical recruiter, and five studies that introduced an automated alert system for identifying eligible participants. The studies were embedded into trials evaluating care in oncology mainly but also in emergency departments, diabetes and lower back pain.
AUTHORS' CONCLUSIONS: There is no strong evidence for any single strategy to help healthcare professionals to recruit participants in research studies. Additional visits or information did not appear to increase recruitment by healthcare professionals. The most promising strategies appear to be those with a dedicated resource (e.g. a clinical recruiter or automated alert system) for identifying suitable participants that reduced the demand on healthcare professionals, but these were assessed in studies at high risk of bias.
识别并接触符合条件的研究参与者以招募其参与研究通常依赖于医疗保健专业人员。这一过程有时会受到有意或无意的把关行为的阻碍，而这种把关可能会在患者选择过程中引入偏差。
我们的主要目的是识别并评估旨在帮助医疗保健专业人员招募研究参与者的策略的效果。
我们于2015年1月5日在以下电子数据库中进行了检索：Cochrane方法学注册库、Cochrane系统评价数据库、医学索引数据库、荷兰医学文摘数据库、护理学与健康领域数据库、英国护理索引、心理学文摘数据库、亚洲社会科学索引和科学引文索引扩展版数据库（自1985年起）。我们检查了所有纳入研究及相关综述文章的参考文献列表，并通过科学引文索引扩展版数据库对所有纳入研究进行了引文追踪。
我们选择了所有评估通过医疗保健专业人员识别并招募研究参与者的策略且提供招募率前后对比数据的研究。
两位综述作者独立筛选检索结果以确定潜在的合格研究，阅读全文，应用选择标准并提取数据。我们计算了每项研究的风险比以表明每种策略的效果。
11项研究符合我们的合格标准，且所有研究均存在中度或高度偏倚风险。只有5项研究给出了参与者总数（总计7372名参与者）。3项研究采用随机设计，其他研究采用前后对比。研究了几种不同的策略。4项研究考察了对研究地点进行额外访问或提供额外信息的影响，结果显示招募人数未增加。两项使用专职临床招募人员的研究以及五项引入用于识别合格参与者的自动警报系统的研究报告了招募率的提高。这些研究主要嵌入到评估肿瘤护理的试验中，但也涉及急诊科、糖尿病和下背痛领域。
没有强有力的证据支持任何单一策略能帮助医疗保健专业人员招募研究参与者。额外访问或提供额外信息似乎并未增加医疗保健专业人员的招募人数。最有前景的策略似乎是那些配备专门资源（如临床招募人员或自动警报系统）来识别合适参与者从而减轻医疗保健专业人员负担的策略，但这些策略在存在高度偏倚风险的研究中得到评估。
