Enrolment patterns in a randomized controlled trial of probiotics in critically ill patients: a retrospective analysis of the PROSPECT trial.

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2024-12-27 DOI:10.1186/s13063-024-08701-w
Alyson Takaoka, Jennie Johnstone, François Lauzier, Diane Heels-Ansdell, Megan Davis, Nicole Zytaruk, Erick Duan, Joanna Dionne, Lois Saunders, Yaseen M Arabi, John Marshall, Lehana Thabane, France Clarke, Lori Hand, Marie-Helene Masse, Bram Rochwerg, Lauralyn McIntyre, Martin Girard, Andreas Freitag, Tim Karachi, Deborah J Cook
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引用次数: 0

Abstract

Background: Understanding site-related factors that influence enrolment within multicenter randomized controlled trials (RCT) may help reduce trial delays and cost over-runs and prevent early trial discontinuation. In this analysis of PROSPECT (Probiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial), we describe patient enrolment patterns and examine factors influencing site-based monthly enrolment.

Design: Retrospective analysis of a multicenter RCT.

Methods: The PROSPECT multicenter RCT enrolled patients in the main trial from July 2015 to March 2019. We documented site characteristics and trial metrics including data from the methods center tracking documents, site-level data at trial initiation, screening logs submitted by research coordinators, and prospectively collected case report forms. In this retrospective analysis of trial data, we analyzed enrolment patterns across sites using negative binomial regression to explore the association between monthly enrolment rate accounting for number of ICU beds, site characteristics, and trial metrics.

Results: Overall, 41 sites enrolling 2365 patients in the PROSPECT main trial were analyzed. After accounting for number of beds in each ICU, site launch early in the trial was associated with higher monthly enrolment rates, but time to first enrolment and research coordinator experience was not. We observed considerable variability in the number of active screening months and enrolment rates across sites.

Conclusion: These findings highlight the complexity of recruitment dynamics in critical care RCTs and emphasize the need for tailored approaches to trial planning and execution.

Trial registration: PROSPECT (Probiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial): NCT02462590 (registered June 2, 2015).

危重患者益生菌随机对照试验的入组模式:PROSPECT试验的回顾性分析
背景:了解影响多中心随机对照试验(RCT)入组的地点相关因素可能有助于减少试验延迟和成本超支,防止试验早期终止。在这项PROSPECT(益生菌:预防严重肺炎和气管内定植试验)的分析中,我们描述了患者的入组模式,并检查了影响基于站点的每月入组的因素。设计:多中心随机对照试验的回顾性分析。方法:2015年7月至2019年3月,PROSPECT多中心随机对照试验纳入主要试验患者。我们记录了地点特征和试验指标,包括来自方法中心跟踪文件的数据、试验开始时的地点水平数据、研究协调员提交的筛选日志和前瞻性收集的病例报告表格。在这项试验数据的回顾性分析中,我们使用负二项回归分析了不同地点的入组模式,以探讨每月入组率与ICU床位数量、地点特征和试验指标之间的关系。结果:总的来说,41个站点纳入了2365名PROSPECT主试验患者。在考虑了每个ICU的床位数量后,试验早期的站点启动与较高的月入组率相关,但首次入组的时间和研究协调员的经验无关。我们观察到不同地点的积极筛查月数和入学率存在相当大的差异。结论:这些发现突出了危重病随机对照试验中招募动态的复杂性,并强调了试验计划和执行的量身定制方法的必要性。试验注册:PROSPECT(益生菌:预防重症肺炎和气管内定植试验):NCT02462590(注册于2015年6月2日)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
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