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针对囊性纤维化患者调整、重启和终止一项随机对照试验:关于新冠疫情对临床人群研究影响的思考

Adapting, restarting, and terminating a randomised control trial for people with cystic fibrosis: Reflections on the impact of the COVID-19 pandemic upon research in a clinical population.

作者信息

Tomlinson Owen W, Barker Alan R, Denford Sarah, Williams Craig A

机构信息

Children's Health and Exercise Research Centre, Department of Public Health and Sports Sciences, University of Exeter, Exeter, United Kingdom.

Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom.

出版信息

Contemp Clin Trials Commun. 2024 Mar 27;39:101294. doi: 10.1016/j.conctc.2024.101294. eCollection 2024 Jun.

Abstract

BACKGROUND

Habitual physical activity (PA) and exercise form a cornerstone of the management of cystic fibrosis (CF), a genetically inherited pulmonary and digestive condition - whereby telehealth platforms have been proposed as a mechanism to engage remotely people with CF in PA and exercise.

METHODS

To test this, in early 2020, the 'ActivOnline: Physical Activity in Cystic Fibrosis Trial' (ActiOn PACT) randomised control trial was established to examine whether an online intervention was effective at increasing PA in adolescents and adults with CF.

RESULTS

The emergence of the COVID-19 pandemic in 2020 forced this trial to be paused and modified, with the adoption of online recruitment and remote assessment of outcome measures. Despite such adaptations in accord with frameworks developed by the National Institute for Health Research, this trial failed to recruit and was subsequently terminated.

CONCLUSIONS

This article details the authors reflections upon the proposed reasons for lack of recruitment, including improved technology and medications for people with CF, and contextualises this finding in relation to the wider issue of non-reporting of trial results in clinical research.

摘要

背景

习惯性身体活动(PA)和锻炼是囊性纤维化(CF)管理的基石,CF是一种遗传性肺部和消化系统疾病,因此远程医疗平台被提议作为让CF患者远程参与PA和锻炼的一种机制。

方法

为了对此进行测试,2020年初开展了“ActivOnline:囊性纤维化患者身体活动试验”(ActiOn PACT)随机对照试验,以检验在线干预对增加CF青少年和成人的PA是否有效。

结果

2020年新冠疫情的出现迫使该试验暂停并进行修改,采用了在线招募和对结果指标的远程评估。尽管这些调整符合英国国家卫生与临床优化研究所制定的框架,但该试验未能完成招募,随后被终止。

结论

本文详细阐述了作者对招募失败原因的思考,包括CF患者的技术和药物有所改进,并将这一发现与临床研究中试验结果未报告这一更广泛问题联系起来。

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