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Arundel CE, Clark LK, Parker A, Beard D, Coleman E, Cooper C, Devane D, Eldridge S, Galvin S, Gillies K, Hewitt CE, Sutton C, Torgerson DJ, Treweek S. Trial Forge Guidance 4: a guideline for reporting the results of randomised Studies Within A Trial (SWATs). Trials 2024; 25:183. [PMID: 38475795 PMCID: PMC10935912 DOI: 10.1186/s13063-024-08004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Evidence to support decisions on trial processes is minimal. One way to generate this evidence is to use a Study Within A Trial (SWAT) to test trial processes or explore methodological uncertainties. SWAT evidence relies on replication to ensure sufficient power and broad applicability of findings. Prompt reporting is therefore essential; however, SWAT publications are often the first to be abandoned in the face of other time pressures. Reporting guidance for embedded methodology trials does exist but is not widely used. We sought therefore to build on these guidelines to develop a straightforward, concise reporting standard, which remains adherent to the CONSORT guideline. METHODS An iterative process was used to develop the guideline. This included initial meetings with key stakeholders, development of an initial guideline, pilot testing of draft guidelines, further iteration and pilot testing, and finalisation of the guideline. RESULTS We developed a reporting guideline applicable to randomised SWATs, including replications of previous evaluations. The guideline follows the Consolidated Standards for Reporting Trials (CONSORT) statement and provides example text to ensure ease and clarity of reporting across all domains. CONCLUSIONS The SWAT reporting guideline will aid authors, reviewers, and journal editors to produce and review clear, structured reports of randomised SWATs, whilst also adhering to the CONSORT guideline. TRIAL REGISTRATION EQUATOR Network - Guidelines Under Development ( https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-clinical-trials/#SWAT ). Registered on 25 March 2021.
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Affiliation(s)
- C E Arundel
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK.
| | - L K Clark
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - A Parker
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - D Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Headington, Oxford, UK
| | - E Coleman
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - C Cooper
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - D Devane
- HRB-Trials Methodology Research Network, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland
| | - S Eldridge
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - S Galvin
- HRB-Trials Methodology Research Network, University of Galway, Galway, Ireland
| | - K Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - C E Hewitt
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - C Sutton
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - D J Torgerson
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - S Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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The effectiveness of incentives for research participation: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2022; 17:e0267534. [PMID: 35452488 PMCID: PMC9032371 DOI: 10.1371/journal.pone.0267534] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/10/2022] [Indexed: 01/21/2023] Open
Abstract
Background Recruitment plays a vital role in conducting randomized control trials (RCTs). Challenges and failure of proper recruitment lead to early termination of trials. Monetary incentives have been suggested as a potential solution to these challenges. Therefore, we aimed to do a systematic review and analysis to evaluate the effect of incentives on the number of participants willing to consent to and participate in RCTs. Methods Electronic databases were systematically searched from inception to September 23rd, 2021, using the following keywords: payments, incentive, response, participation, enrollment, randomized, randomization, and RCT. The Cochrane Risk of Bias tool was used to assess the quality of the included trials. Risk ratios (RRs) were calculated with their corresponding 95% confidence interval (CI). All analyses were done with the random-effects model. We used Revman software to perform the analysis. Results Six RCTs with 6,253 Participants met the inclusion criteria. Our analysis showed significant improvement in response rate (RR: 1.27; 95% CI: 1.04, 1.55; P = 0.02) and consent rates (RR: 1.44; 95% CI: 1.11, 1.85; P = 0.006) when an incentive payment was offered to participants. Even a small amount of incentive showed significant improvement in both consent (RR: 1.33; 95% CI: 1.03, 1.73; P = 0.03) and response rates (RR: 1.26; 95% CI: 1.08, 1.47; P = 0.004). Conclusion In conclusion, our meta-analysis demonstrated statistically significant increases in the rate of consent and responses from participants when offered even small monetary value incentives. These findings suggest that incentives may be used to reduce the rate of recruitment failure and subsequent study termination. However, further RCTs are needed to establish a critical threshold beyond which incentive amount does not alter response rates further and the types of RCTs in which financial incentives are likely to be effective.
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Gillies K, Kearney A, Keenan C, Treweek S, Hudson J, Brueton VC, Conway T, Hunter A, Murphy L, Carr PJ, Rait G, Manson P, Aceves-Martins M. Strategies to improve retention in randomised trials. Cochrane Database Syst Rev 2021; 3:MR000032. [PMID: 33675536 PMCID: PMC8092429 DOI: 10.1002/14651858.mr000032.pub3] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Poor retention of participants in randomised trials can lead to missing outcome data which can introduce bias and reduce study power, affecting the generalisability, validity and reliability of results. Many strategies are used to improve retention but few have been formally evaluated. OBJECTIVES To quantify the effect of strategies to improve retention of participants in randomised trials and to investigate if the effect varied by trial setting. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Scopus, PsycINFO, CINAHL, Web of Science Core Collection (SCI-expanded, SSCI, CPSI-S, CPCI-SSH and ESCI) either directly with a specified search strategy or indirectly through the ORRCA database. We also searched the SWAT repository to identify ongoing or recently completed retention trials. We did our most recent searches in January 2020. SELECTION CRITERIA We included eligible randomised or quasi-randomised trials of evaluations of strategies to increase retention that were embedded in 'host' randomised trials from all disease areas and healthcare settings. We excluded studies aiming to increase treatment compliance. DATA COLLECTION AND ANALYSIS We extracted data on: the retention strategy being evaluated; location of study; host trial setting; method of randomisation; numbers and proportions in each intervention and comparator group. We used a risk difference (RD) and 95% confidence interval (CI) to estimate the effectiveness of the strategies to improve retention. We assessed heterogeneity between trials. We applied GRADE to determine the certainty of the evidence within each comparison. MAIN RESULTS We identified 70 eligible papers that reported data from 81 retention trials. We included 69 studies with more than 100,000 participants in the final meta-analyses, of which 67 studies evaluated interventions aimed at trial participants and two evaluated interventions aimed at trial staff involved in retention. All studies were in health care and most aimed to improve postal questionnaire response. Interventions were categorised into broad comparison groups: Data collection; Participants; Sites and site staff; Central study management; and Study design. These intervention groups consisted of 52 comparisons, none of which were supported by high-certainty evidence as determined by GRADE assessment. There were four comparisons presenting moderate-certainty evidence, three supporting retention (self-sampling kits, monetary reward together with reminder or prenotification and giving a pen at recruitment) and one reducing retention (inclusion of a diary with usual follow-up compared to usual follow-up alone). Of the remaining studies, 20 presented GRADE low-certainty evidence and 28 presented very low-certainty evidence. Our findings do provide a priority list for future replication studies, especially with regard to comparisons that currently rely on a single study. AUTHORS' CONCLUSIONS Most of the interventions we identified aimed to improve retention in the form of postal questionnaire response. There were few evaluations of ways to improve participants returning to trial sites for trial follow-up. None of the comparisons are supported by high-certainty evidence. Comparisons in the review where the evidence certainty could be improved with the addition of well-done studies should be the focus for future evaluations.
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Affiliation(s)
- Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Anna Kearney
- Dept. of Health Data Science, University of Liverpool, Liverpool, UK
| | - Ciara Keenan
- Campbell UK & Ireland, Centre for Evidence and Social Innovation, Queen's University, Belfast, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jemma Hudson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Valerie C Brueton
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College, London, UK
| | - Thomas Conway
- Clinical Research Facility Galway, National University of Ireland Galway, Galway, Ireland
| | - Andrew Hunter
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Louise Murphy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Peter J Carr
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Greta Rait
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Paul Manson
- Health Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK
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