削弱青少年临床研究的转化潜力:COVID-19期间随机临床试验的入组差异。

IF 2.4 4区 医学 Q3 INFECTIOUS DISEASES
Sexually transmitted diseases Pub Date : 2024-10-01 Epub Date: 2024-05-01 DOI:10.1097/OLQ.0000000000001994
Jamie Perin, Jennifer Anders, Ashle Barfield, Charlotte Gaydos, Richard Rothman, Pamela A Matson, Steven Huettner, Jacquelyn Toppins, Maria Trent
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引用次数: 0

摘要

背景:COVID-19 的留院令和研究限制停止了临床研究患者的招募和随访。虽然临床研究已经恢复,但研究参与度是否已恢复到 COVID-19 之前的水平仍是一个悬而未决的问题:我们利用了 TECH-PN(NCT# NCT03828994)研究的数据,该研究是一项单中心 RCT,招募了 13-25 岁患有轻度-中度盆腔炎 (PID) 并接受非住院治疗的患者。我们通过估算每个时期的平均招募就诊率,研究了 COVID-19 之前和 COVID-19 期间/之后经评估符合条件者的招募模式。我们重点研究了按流行病状况划分的月率,按流行病状况划分的住院时间(LOS),以及住院时间与患者人口统计学之间的关系。我们进行了描述性分析,包括学生 t 检验来比较不同时期的比率,以及 Chi-square 检验来比较拒绝注册的比例:结果:大流行期间/大流行后的每月注册率明显低于 COVID-19 前(每月 4.8 人,而 COVID-19 前为每月 7.4 人,P < 0.001)。不过,大流行前后符合条件的参与者的年龄、种族和保险类型相似。在符合条件的患者中,接受 PID 治疗的 LOS 略有增加,从中位数 5.4 小时增加到 6.4 小时(p = 0.650),符合条件的患者中拒绝参与的比例相似(23% 对 27%,p = 0.362)。两个时期因住院而不符合条件的患者人数相似:结论:COVID-19 大流行的限制对该 RCT 的招募产生了负面影响。招募人数的差异可能反映了人们对就医限制的持续看法或对使用医疗服务的犹豫不决。需要开展更多的研究,以稳定非住院性传播疾病/艾滋病护理和临床试验的可及性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Undermining the Translational Potential of Clinical Research With Adolescents and Young Adults: Differential Enrollment in Randomized Clinical Trials During COVID-19.

Background: COVID-19 stay-at-home orders and research restrictions halted recruitment and follow-up of clinical research patients. Although clinical research has resumed, it is an open question whether research participation has returned to levels similar to those before COVID-19.

Methods: We used data from the TECH-PN (NCT No. NCT03828994) study, a single-center randomized controlled trial enrolling 13- to 25-year-olds with mild-moderate pelvic inflammatory disease (PID) receiving ambulatory care. We examined enrollment patterns before COVID-19 and during/after COVID-19 among those assessed for eligibility by estimating the average rate of recruitment visits for each period. We focused on this monthly rate by pandemic status, the length of stay (LOS) by pandemic status, as well as the relationship between the LOS and patient demographics. Descriptive analyses were conducted, including Student t test to compare rates between time periods and a χ2 test to compare the proportion refusing enrollment.

Results: The monthly enrollment rate during/after the pandemic was significantly lower than before COVID-19 (4.8 per month compared with 7.4 per month, P < 0.001). However, eligible participants' age, race, and insurance type were similar before and during/after the pandemic. Among eligible patients, LOS for receiving PID care was slightly increased, from a median of 5.4 to 6.4 hours ( P = 0.650), and the rate of refusal to participate among those eligible was similar (23% vs. 27%, P = 0.362). There were a similar number of ineligible patients because of inpatient admissions during both periods.

Conclusion: COVID-19 pandemic restrictions negatively impacted recruitment into this randomized controlled trial. Enrollment differences may reflect ongoing perceptions of restrictions in care access or a hesitancy to use health services. More research is needed to stabilize access to ambulatory sexually transmitted infection/PID care and access to clinical trials.

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来源期刊
Sexually transmitted diseases
Sexually transmitted diseases 医学-传染病学
CiteScore
4.00
自引率
16.10%
发文量
289
审稿时长
3-8 weeks
期刊介绍: ​Sexually Transmitted Diseases, the official journal of the American Sexually Transmitted Diseases Association​, publishes peer-reviewed, original articles on clinical, laboratory, immunologic, epidemiologic, behavioral, public health, and historical topics pertaining to sexually transmitted diseases and related fields. Reports from the CDC and NIH provide up-to-the-minute information. A highly respected editorial board is composed of prominent scientists who are leaders in this rapidly changing field. Included in each issue are studies and developments from around the world.
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