Development of a framework to improve the process of recruitment to randomised controlled trials (RCTs): the SEAR (Screened, Eligible, Approached, Randomised) framework.
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Date
2018-01-19ICR Author
Author
Wilson, C
Rooshenas, L
Paramasivan, S
Elliott, D
Jepson, M
Strong, S
Birtle, A
Beard, DJ
Halliday, A
Hamdy, FC
Lewis, R
Metcalfe, C
Rogers, CA
Stein, RC
Blazeby, JM
Donovan, JL
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: Research has shown that recruitment to trials is a process that stretches from identifying potentially eligible patients, through eligibility assessment, to obtaining informed consent. The length and complexity of this pathway means that many patients do not have the opportunity to consider participation. This article presents the development of a simple framework to document, understand and improve the process of trial recruitment. METHODS: Eight RCTs integrated a QuinteT Recruitment Intervention (QRI) into the main trial, feasibility or pilot study. Part of the QRI required mapping the patient recruitment pathway using trial-specific screening and recruitment logs. A content analysis compared the logs to identify aspects of the recruitment pathway and process that were useful in monitoring and improving recruitment. Findings were synthesised to develop an optimised simple framework that can be used in a wide range of RCTs. RESULTS: The eight trials recorded basic information about patients screened for trial participation and randomisation outcome. Three trials systematically recorded reasons why an individual was not enrolled in the trial, and further details why they were not eligible or approached, or declined randomisation. A framework to facilitate clearer recording of the recruitment process and reasons for non-participation was developed: SEAR - Screening, to identify potentially eligible trial participants; Eligibility, assessed against the trial protocol inclusion/exclusion criteria; Approach, the provision of oral and written information and invitation to participate in the trial, and Randomised or not, with the outcome of randomisation or treatment received. CONCLUSIONS: The SEAR framework encourages the collection of information to identify recruitment obstacles and facilitate improvements to the recruitment process. SEAR can be adapted to monitor recruitment to most RCTs, but is likely to add most value in trials where recruitment problems are anticipated or evident. Further work to test it more widely is recommended.
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Subject
Humans
Treatment Outcome
Endpoint Determination
Sample Size
Patient Selection
Eligibility Determination
Randomized Controlled Trials as Topic
Clinical Decision-Making
Research team
Clinical Trials & Statistics Unit
Language
eng
Date accepted
2017-12-14
License start date
2018-01-19
Citation
Trials, 2018, 19 (1), pp. 50 - ?
Publisher
BMC