Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops

Objectives

To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs).

Study Design and Setting

Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified.

Results

Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research.

Conclusions

We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated.

ISCB-Student Council Narratives: Strategical development of the ISCB-Regional Student Groups in 2016

Regional Student Groups are groups established and managed by the ISCB-Student Council in different regions of the world. The article highlights some of the initiatives and management lessons from our 'top-performing' Spotlight Regional Student Groups (RSGs), RSG-Argentina and RSG-UK, for the current year (2016). In addition, it details some of the operational hurdles faced by RSGs and possible solutions.

[How we harmonize HSCT clinical practices among the SFGM-TC centers]

In hematopoietic transplantation, clinical patient care is localized and practices differ from one country to another and even from center to center. International guidelines are not always well adapted to the evolution of daily clinical practice, and they do not address all issues, especially practical ones. Therefore, in the absence of well-established guidelines, each center tends to make do by developing local procedures. In the attempt to harmonize localized clinical practices between different centers belonging to the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC), our society set up in 2010 what would become an annual workshop series, bringing together practitioners from all member centers. Each workshop group is responsible for discussing a specific issue and then drafting, in the form of an article, a set of guidelines that address the issue practically. With the aim of covering all practical issues and providing widely-usable guidelines when international consensus is lacking, the SFGM-TC has succeeded in establishing national guidelines by those who use them. So as to be easily localized by all centers, the guidelines are written in French. In this article, we set out the process by which the workshops are conducted and how the final guidelines produced are approved each year.

[Are there too many conferences for general and visceral surgery in Germany? : A survey of DGAV members]

BACKGROUND

Human and financial resources are increasingly bound due to economic pressure and the working hours Act whereby the already restricted further training times are further limited. The industry also has less funding available for sponsorship of conferences and workshops. Against this background the question arises whether a reduction or focusing of the conferences is necessary; therefore, the aim of this survey was to obtain an opinion from members of the German Society of General and Visceral Surgery (DGAV) and possibly to derive a need for action to submit to the board members.

METHODS

From 7 February to 18 March 2015 an online survey was conducted by the DGAV with their members regarding the number of necessary congress events in Germany.

RESULTS

A total of 670 responses were received (return rate 16 %). In total, 56 % of participants felt that there are too many conferences. A differentiation according to the position of the respondent and the level of the associated hospital resulted in the following: 69.3 % of the participating head physicians (HP) shared this opinion, compared to 48.6 % of senior physicians (SP) and 34.4 % of residents (RP). Of the participants from basic and standard care hospitals (B/SC) 50 % shared this opinion, compared to 59.2 % from maximum care hospitals (MC) and 63.6 % from university hospitals (UH). In addition, a total of 75 % of the participants (HP 82.9 %, SP 78.4 %, RP 70.5 %) were in favor of keeping the congress of the DGAV (annual meeting of the German Society for Digestive and Metabolic Diseases in conjunction with the Autumn meeting of the DGAV) in its previous form, regardless of the underlying level of care of the associated hospital (B/SC 77 %, MC 79 %, UC 68 %).

CONCLUSION

More experienced surgeons in particular tended to favor a reduction of events with a focus on the major conferences; however, younger colleagues preferred a wider spectrum of meetings. In order to comply with both positions a wide range of events should be continued to be provided in the future so that surgeons can choose which to attend according to the individual preferences.

Hands-on workshops as an effective means of learning advanced technologies including genomics, proteomics and bioinformatics

Genomics and proteomics have emerged as key technologies in biomedical research, resulting in a surge of interest in training by investigators keen to incorporate these technologies into their research. At least two types of training can be envisioned in order to produce meaningful results, quality publications and successful grant applications: (1) immediate short-term training workshops and (2) long-term graduate education or visiting scientist programs. We aimed to fill the former need by providing a comprehensive hands-on training course in genomics, proteomics and informatics in a coherent, experimentally-based framework. This was accomplished through a National Heart, Lung, and Blood Institute (NHLBI)-sponsored 10-day Genomics and Proteomics Hands-on Workshop held at National Jewish Health (NJH) and the University of Colorado School of Medicine (UCD). The course content included comprehensive lectures and laboratories in mass spectrometry and genomics technologies, extensive hands-on experience with instrumentation and software, video demonstrations, optional workshops, online sessions, invited keynote speakers, and local and national guest faculty. Here we describe the detailed curriculum and present the results of short- and long-term evaluations from course attendees. Our educational program consistently received positive reviews from participants and had a substantial impact on grant writing and review, manuscript submissions and publications.

Training workshops positively impact beliefs about contingency management in a nationwide dissemination effort

In 2011, the Veterans Administration called for nationwide implementation of contingency management (CM) in its intensive outpatient substance use disorders treatment programs, and this study evaluated the impact of the initial 1 and ½ day training workshops on knowledge and perceptions about CM among 159 clinical leaders from 113 clinics. Workshop attendance significantly increased CM-related knowledge (d=1.88) and changed attendees' perceptions of CM (ds=0.26-0.74). Endorsement of barriers to CM adoption decreased and positive impressions of CM increased. These perceptions about CM emerged as key correlates of post-training preparedness to implement CM. Results suggest that training workshops can be an effective avenue for increasing CM-related knowledge, as well as addressing persistent misperceptions about CM that may impede adoption efforts. Continued efforts to introduce educational materials and offer training and consultation opportunities may increase understanding about this evidence-based intervention among clinicians, thereby leading to improved patient outcomes.

Population education through poetry

The State Council of Education Research and Training (SCERT) in Haryana has adopted a stimulating approach in propagating messages of population -- through poetry. Through a project called Students Poetical Symposiums, the first phase convened around 20 teacher poets to participate in a workshop. In this workshop, 300 poems regarding six population themes were developed by the teachers. In the second phase, the developed poems were finalized by the experts and 108 poems were selected for publication in a booklet. The poems were classified according to the following themes: population and its effects on resources, effects of population growth, population growth and environment, population growth and economic aspect, population and social aspect, and population and emotional aspect. Each of these sections has 18 poems. The booklet also provides the users with guidelines for conducting Students' Poetical Symposiums. In the third phase, 36 schools were selected and oriented about this project. Students Poetical Symposiums were organized first at school level and later at the district level. More than 500 student poets recited the poems on the population education themes during 42 symposiums at the school and district levels to an audience numbering around ten thousand, comprising both students and the public.

Zambia moves towards reproductive health

Several events in Zambia this year have marked the development of an integrated approach to reproductive health. A team met in March to draw up a national safe motherhood policy, plus strategies and guidelines. These were completed by April and are being distributed for comments. Clinical guidelines for safe motherhood in health centers have also been developed. These aim to reduce mortality and morbidity among mothers and infants by helping health workers to provide quality care to women at every stage of pregnancy and delivery. A reproductive health workshop was held in Ngwerere in May to create awareness of the concept of reproductive health, identify reproductive health problems in the area, propose solutions and outline activities. The 75 participants included community health workers, community leaders, teachers, youth leaders, and community members, as well as health workers and policymakers. The workshop was conducted in the local language so that those present were able to participate fully. June 1997 saw the official launch of Zambia's new policy framework, guidelines and strategy on family planning within reproductive health. The country's Minister of Health, Dr. Katele Kalumba, said the family planning guidelines were a sign of the government's commitment to providing a basic health care package for all Zambians. To promote widespread discussion of the whole concept of reproductive health, local newspapers printed feature articles with the headline "Let's talk reproductive health." The articles raised a variety of sensitive issues that ranged from safe sex and adolescent sexuality to safe motherhood and HIV prevention. Plans are going ahead in Zambia for drawing up a national training curriculum for safe motherhood and family planning. The curriculum for health workers will cover both pre-service and in-service training.