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Nagla A, Le B, White C, V Kiburg K, Philip J. Attitudes of Palliative Care Practitioners Towards Enrolling Patients in Clinical Trials. J Palliat Care 2022; 37:447-455. [PMID: 35546098 DOI: 10.1177/08258597211063057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Recruitment of participants for clinical trials remains a key consideration for investigators. This is particularly relevant in palliative care, where practitioners are sometimes reluctant to refer patients for consideration of enrolment. Reasons for this reluctance range from concerns about excessive burden to patients, through to debate about the appropriateness of undertaking trials in the palliative care setting. Aim: The aim of this study was (1) to explore palliative care practitioners' attitudes and views of clinical trials, (2) to compare these findings with those of a similar survey undertaken more than a decade earlier, and (3) to explore predictors associated with key concepts of interest associated with clinical trials. Design: The palliative care clinician's attitudes to clinical research survey undertaken in 2007 formed the basis of a repeat survey conducted in 2019. Setting/Participants: Australian and New Zealand palliative care practitioners were surveyed. Results: Surveys were completed by 135 palliative care practitioners. Comparing results of the current study and those findings of more than a decade earlier revealed that attitudes have either not substantially changed or indeed in some areas have become less accepting of clinical trials. This is despite the dramatic increase in the volume of research carried out within palliative care over the last decade. Conclusion: Our survey suggests that the reasons for engagement in research are complex and likely to differ according to local conditions. Careful attention to understanding of the local environment and particularly the attitudes of local practitioners is likely to be essential to be successful in this endeavour.
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Affiliation(s)
- Ahmed Nagla
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Brian Le
- Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Clare White
- Northern Ireland Hospice, Belfast, Northern Ireland and Belfast Health and Social Care Trust
| | | | - Jennifer Philip
- Peter MacCallum Cancer Centre, Melbourne, Australia.,St Vincent's Hospital Melbourne, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
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Perceived Barriers to Clinical Cardiovascular Research Involvement in Canada. CJC Open 2021; 3:1089-1090. [PMID: 34505050 PMCID: PMC8413250 DOI: 10.1016/j.cjco.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/21/2021] [Indexed: 11/24/2022] Open
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AlSardi M, AlAskar D, Alsahafi M, AlAmeel T, Al Sulais E. Barriers to research productivity among gastroenterologists and hepatologists in Saudi Arabia. Saudi J Gastroenterol 2020; 27:73-78. [PMID: 33154205 PMCID: PMC8183365 DOI: 10.4103/sjg.sjg_332_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Clinical research is essential for the advancement of medical knowledge and evidence-based medical practice. In this study, we aimed to identify barriers that limit research productivity among gastroenterologists in Saudi Arabia. METHODS We conducted a national online survey targeting gastroenterologists in Saudi Arabia. Participants were asked about the patterns of their practice, their prior research activities, and potential barriers to research productivity. Univariate and multivariate analyses were performed to examine the association between different factors and research productivity. RESULTS A total of 85 gastroenterologists completed the survey. Respondents were predominantly male physicians (90.6%) and 40% of them belonged to the age group of 40-49 years. About 85.9% had at least one prior research participation of any type. Around 67.1% of the respondents had been a primary investigator at least once in the last 5 years, while only 23.5% had been a primary investigator at a minimum average rate of once a year. Multiple barriers to research productivity were identified: insufficient research time (78.8%), lack of funding and compensation (77.6%), lack of a statistician (68.2%), insufficient research training (64.7%), lack of connection (60%), lack of technical support (57.6%), and lack of interest (31%). On univariate analysis, insufficient research time and lack of funding and compensation were significantly associated with no research participation (P <0.01 and 0.03, respectively). On multivariate analysis, lack of funding and compensation was independently associated with no research participation (adjusted OR 15.32;95% C.I 2.66, 121.58, P < 0.01). CONCLUSIONS Barriers to research productivity are highly prevalent among gastroenterologists in Saudi Arabia. Insufficient research time and lack of funding and compensation are the most common. Interventions are needed to promote research activities.
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Affiliation(s)
- Mais AlSardi
- Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Dimah AlAskar
- Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Majid Alsahafi
- Division of Gastroenterology, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Turki AlAmeel
- Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Eman Al Sulais
- Department of Medicine, Royal Commission Hospital, Jubail, Saudi Arabia,Address for correspondence: Dr. Eman Al Sulais, Department of Medicine, Royal Commission Hospital, Jubail, 31961, Saudi Arabia. E-mail:
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Messner DA, Moloney R, Warriner AH, Wright NC, Foster PJ, Saag KG. Understanding practice-based research participation: The differing motivations of engaged vs. non-engaged clinicians in pragmatic clinical trials. Contemp Clin Trials Commun 2016; 4:136-140. [PMID: 29736476 PMCID: PMC5935887 DOI: 10.1016/j.conctc.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 11/17/2022] Open
Abstract
Background/Aims Pragmatic clinical trials (PCTs) represent an increasingly used strategy for “real-world” trials. Successful PCTs typically require participation of community-based practices. However, community clinicians often have limited interest or experience in clinical research. Many barriers to practice-based research have been described, but possible motivations to participate among community practices not active in research have not been well explored. The tendency is for researchers to assume similar motivations and priorities across all candidate practices. This is not necessarily the case. A better understanding of the range of reasons clinicians might see for participating in pragmatic trials could be key to promoting this type of practice-based research. Methods Semi-structured interviews were conducted with 30 clinicians and staff members. Half of the interviewees had experience doing practice-based clinical trials and half did not. Individuals in these two groups were also diversified in terms of their practice size and location. Participants were asked about motivations and barriers to doing practice-based research in the context of a planned osteoporosis pragmatic clinical trial. Interviews were transcribed, coded, and analyzed. Results Barriers identified for both experienced and not-experienced clinicians and staff members included: a lack of time, increased paperwork, disruption to work flows, and concern over practice finances. Similar findings have been reported in the US, UK, Europe, and Australia. However, regarding positive motivations of practices to participate, we found systematic differences in attitude between research-engaged and research-naïve practices that have not been previously reported. The research-experienced group offered a greater number and variety of reasons to take part than the not-experienced group. While both groups expressed motivations related to patient care, clinicians and staff members experienced in practice-based clinical trials were much more likely to cite intellectual, professional, and societal benefits not envisioned by the other group. Conclusions We conclude that clinicians not already participating in practice-based trials may have a narrower range of motivations than those already participating. The lack of a broader view of possible benefits to participation may also translate into more obdurate recruiting challenges. These results point to the need for recruitment, engagement, and messaging approaches differentially tailored to the needs and interests of non-participating practices.
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Affiliation(s)
| | | | - Amy H Warriner
- Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, USA
| | - Phillip J Foster
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
| | - Kenneth G Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
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Caixeiro NJ, Byun HL, Descallar J, Levesque JV, de Souza P, Soon Lee C. Health professionals' opinions on supporting a cancer biobank: identification of barriers to combat biobanking pitfalls. Eur J Hum Genet 2016; 24:626-32. [PMID: 26328505 PMCID: PMC4930095 DOI: 10.1038/ejhg.2015.191] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 06/17/2015] [Accepted: 07/28/2015] [Indexed: 11/08/2022] Open
Abstract
Although rarely acknowledged, a successful biobank is highly dependent on the support of the health professionals who assist the biobank in all aspects of its activities. In many cases, the lack of health professional support can be a limiting factor in the biobanking process of collecting and processing high-quality biospecimens. The aim of this study was to determine the attitudes of health professionals towards cancer biobanking. Using a 5-point Likert scale questionnaire, important aspects of biobanking, including accrual, quality, knowledge, responsiveness, impact, access, trust, governance and accreditation, were investigated. In total, 95 of 124 health and medical practitioners who were approached participated in this study (77% response rate). Health professionals in general supported the aims of biobanking with 56% of participants showing willingness to create a biobank and recruit donors (accrual), 85% understanding the importance in the storage and distribution of biospecimens (quality), 88% having an appreciation for the role of a biobank in furthering cancer research (knowledge), 70% showing awareness of the use of biospecimens in future research initiatives (responsiveness) and 73% demonstrating support for a biobank with proper control, authority and credibility measures in place (governance and accreditation). Overall, provided that proper information about the activities of the biobank and researcher access was transparent, health professionals were very willing to support cancer biobanking. These findings may assist in developing strategies for the establishment and maintenance of biobanks and aid the implementation of more effective policies and procedures to embed biobanking into routine hospital practices.
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Affiliation(s)
- Nicole J Caixeiro
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Discipline of Pathology, School of Medicine, University of Western Sydney, Liverpool, NSW, Australia
| | - Hei Lan Byun
- Department of Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
- Psycho-Oncology Research Group, University of New South Wales, Sydney, NSW, Australia
| | - Paul de Souza
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Discipline of Pathology, School of Medicine, University of Western Sydney, Liverpool, NSW, Australia
- Department of Oncology, Liverpool Hospital, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cheok Soon Lee
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Discipline of Pathology, School of Medicine, University of Western Sydney, Liverpool, NSW, Australia
- Department of Oncology, Liverpool Hospital, Liverpool, NSW, Australia
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Paget SP, Lilischkis KJ, Morrow AM, Caldwell PHY. Embedding research in clinical practice: differences in attitudes to research participation among clinicians in a tertiary teaching hospital. Intern Med J 2014; 44:86-9. [PMID: 24450523 DOI: 10.1111/imj.12330] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 04/24/2013] [Indexed: 11/28/2022]
Abstract
Despite a drive to increase research in healthcare settings, clinician participation in research remains infrequent. This paper describes an online survey comparing attitudes with research participation among clinicians (doctors, nurses and allied health professionals) at an Australian tertiary children's hospital. Differences between professional groups support the existence of different professional cultures surrounding research, suggesting that multiple strategies are required to improve participation in research.
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Affiliation(s)
- S P Paget
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Recruitment in pediatric clinical research was influenced by study characteristics and pediatricians' perceptions: a multicenter survey. J Clin Epidemiol 2013; 66:1151-7. [DOI: 10.1016/j.jclinepi.2013.04.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 03/28/2013] [Accepted: 04/11/2013] [Indexed: 11/20/2022]
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8
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Kukafka R, Allegrante JP, Khan S, Bigger JT, Johnson SB. Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings. Contemp Clin Trials 2013; 36:166-74. [DOI: 10.1016/j.cct.2013.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/12/2013] [Accepted: 06/16/2013] [Indexed: 11/16/2022]
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Aljadi SH, Alrowayeh HN, Alotaibi NM, Taaqi MM, Alquraini H, Alshatti TA. Research amongst physical therapists in the state of Kuwait: participation, perception, attitude and barriers. Med Princ Pract 2013; 22:561-6. [PMID: 23988758 PMCID: PMC5586803 DOI: 10.1159/000354052] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 06/17/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The objectives of this descriptive study were to investigate the attitudes and perceptions of physical therapists regarding research, the intention to engage in research and the barriers to participating in research amongst physical therapists in the State of Kuwait. SUBJECTS AND METHODS A previously validated questionnaire was distributed to 200 non-randomly selected physical therapists. The questionnaire gathered demographic data as well as information regarding research-related activities. Descriptive statistics, frequency and χ(2) analyses were used in this study. RESULTS Of the 200 questionnaires distributed to physical therapists 122 (61%) were completed and returned. The physical therapists had a positive attitude towards reading these findings in order to update their knowledge. However, only 16 (17%) of the physical therapists participated in clinical research. The common reasons given were: minimal role and reduced ability, intention and level of engagement in initiating research, probably due to work overload, time constraints and limited access to resources. CONCLUSIONS Physical therapists in Kuwait had a positive attitude towards the application of research findings to their practice. However, they were not confident in initiating research due to work overload and lack of time as well as limited access to library resources. Therefore, we recommend stimulation to engage in research activities to be a requirement and to develop a system to improve the skills and knowledge of doing research.
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Affiliation(s)
- Sameera H. Aljadi
- Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Sulaibikhat, Kuwait
- *Assist. Prof. Sameera H. Aljadi, PhD, PT, Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, PO Box 31470, Sulaibikhat 90805 (Kuwait), E-Mail
| | - Hesham N. Alrowayeh
- Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Sulaibikhat, Kuwait
| | - Naser M. Alotaibi
- Department of Occupational Therapy, Faculty of Allied Health Sciences, Kuwait University, Sulaibikhat, Kuwait
| | - Maqdad M. Taaqi
- Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Sulaibikhat, Kuwait
| | - Habib Alquraini
- Department of Health Information Administration, Faculty of Allied Health Sciences, Kuwait University, Sulaibikhat, Kuwait
| | - Talal A. Alshatti
- Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Sulaibikhat, Kuwait
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Grand MM, O'Brien PC. Obstacles to participation in randomised cancer clinical trials: a systematic review of the literature. J Med Imaging Radiat Oncol 2012; 56:31-9. [PMID: 22339743 DOI: 10.1111/j.1754-9485.2011.02337.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Accrual to clinical trials continues to be a problem in many countries including Australia despite its fundamental importance to the progress of evidence-based medicine. This paper reviews the current literature addressing the obstacles to accrual excluding those related to protocol design. An electronic search of the literature identified publications in oncology specifically addressing the obstacles to participation in clinical trials. This search was supplemented by searches of key oncology journals. Obstacles fall into three main categories - clinician, patient and system; however, there are overlaps between categories. Clinician behaviour is the most important of these. Exclusion of patients for reasons other than defined eligibility criteria, concerns about increased time requirements, and suboptimal communication with patients all affect accrual. Risk management strategies for clinical trials need to be individualised to address the obstacles most likely to negatively impact on accrual. Communication between clinician and patient appears to be a greater issue than previously recognised. Time concerns need to be addressed as generational change affects the expectations of the medical workforce.
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Affiliation(s)
- Melissa M Grand
- TROG Cancer Research, Calvary Mater Newcastle Calvary Mater Newcastle University of Newcastle, HRMC, New South Wales, Australia
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Ford E, Jenkins V, Fallowfield L, Stuart N, Farewell D, Farewell V. Clinicians' attitudes towards clinical trials of cancer therapy. Br J Cancer 2011; 104:1535-43. [PMID: 21487408 PMCID: PMC3101903 DOI: 10.1038/bjc.2011.119] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Patient accrual into cancer clinical trials remains at low levels. This survey elicited attitudes and practices of cancer clinicians towards clinical trials. Method: The 43-item Clinicians Attitudes to Clinical Trials Questionnaire was completed by participants in an intervention study aimed at improving multi-disciplinary involvement in randomised trials. Responses from 13 items were summed to form a research-orientation score. Results: Eighty-seven clinicians (78%) returned questionnaires. Physicians, more often than surgeons, chose to prioritise prolonging a patient's life, recruited ⩾50% of patients into trials and attended more research-focussed conferences. Clinicians at specialist centres were more positive about trials with no-treatment arms than those at district general hospitals, more likely to believe clinician, rather than patient reluctance to participate was the greater obstacle to trial accrual, and preferred national and international to local recognition. Clinicians belonging to breast and colorectal teams were less disappointed about not enrolling patients in trials and more accepting of no-treatment arm trials. Research orientation was higher in physicians than surgeons and higher in specialist centres than district hospitals. Conclusions: This study provides greater understanding of clinicians’ attitudes to trials. Results have been used to inform training interventions for clinicians targeting the problem of low and selective accrual.
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Affiliation(s)
- E Ford
- Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9QG, UK.
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Tooher RL, Middleton PF, Crowther CA. A thematic analysis of factors influencing recruitment to maternal and perinatal trials. BMC Pregnancy Childbirth 2008; 8:36. [PMID: 18687110 PMCID: PMC2532678 DOI: 10.1186/1471-2393-8-36] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Accepted: 08/07/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recruitment of eligible participants remains one of the biggest challenges to successful completion of randomised controlled trials (RCTs). Only one third of trials recruit on time, often requiring a lengthy extension to the recruitment period. We identified factors influencing recruitment success and potentially effective recruitment strategies. METHODS We searched MEDLINE and EMBASE from 1966 to December Week 2, 2006, the Cochrane Library Methodology Register in December 2006, and hand searched reference lists for studies of any design which focused on recruitment to maternal/perinatal trials, or if no studies of maternal or perinatal research could be identified, other areas of healthcare. Studies of nurses' and midwives' attitudes to research were included as none specifically about trials were located. We synthesised the data narratively, using a basic thematic analysis, with themes derived from the literature and after discussion between the authors. RESULTS Around half of the included papers (29/53) were specific to maternal and perinatal healthcare. Only one study was identified which focused on factors for maternal and perinatal clinicians and only seven studies considered recruitment strategies specific to perinatal research. Themes included: participant assessment of risk; recruitment process; participant understanding of research; patient characteristics; clinician attitudes to research and trials; protocol issues; and institutional or organisational issues. While no reliable evidence base for strategies to enhance recruitment was identified in any of the review studies, four maternal/perinatal primary studies suggest that specialised recruitment staff, mass mailings, physician referrals and strategies targeting minority women may increase recruitment. However these findings may only be applicable to the particular trials and settings studied. CONCLUSION Although factors reported by both participants and clinicians which influence recruitment were quite consistent across the included studies, studies comparing different recruitment strategies were largely missing. Trials of different recruitment strategies could be embedded in large multicentre RCTs, with strategies tailored to the factors specific to the trial and institution.
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Affiliation(s)
- Rebecca L Tooher
- Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia
| | - Philippa F Middleton
- Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia
| | - Caroline A Crowther
- Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia
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Agustin C, Grand M, Gebski V, Turner S. Radiation therapists’ perspective on barriers to clinical trials research. J Med Imaging Radiat Oncol 2008; 52:178-82. [DOI: 10.1111/j.1440-1673.2008.01938.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Grimwood K, Huang QS, Cohet C, Gosling IA, Hook SM, Teele DW, Pinnock RE, Nicholson WR, Graham DA, Farrell AP, Leadbitter P, Lennon DR. Rotavirus hospitalisation in New Zealand children under 3 years of age. J Paediatr Child Health 2006; 42:196-203. [PMID: 16630321 DOI: 10.1111/j.1440-1754.2006.00829.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To describe the epidemiology of severe rotavirus gastroenteritis and to estimate the hospitalisation rates of this illness in New Zealand children under 3 years of age. METHODS Children under 3 years of age with acute diarrhoea admitted to 1 of 8 study hospitals between 1 May 1998 and 30 April 2000 were surveyed. Their socio-demographic, treatment and length-of-stay data were recorded and stool samples tested by a rotavirus-specific enzyme-linked immunoassay. National hospital discharge data for infectious diarrhoea (International Classification of Diseases, ninth revision, 003-009) were reviewed, allowing population-based estimates for rotavirus-related hospitalisation in New Zealand. RESULTS Of 2019 enrolled children, 1138 (56.4%) provided stools for testing, and of these 485 (42.6%) tested rotavirus positive. Rotavirus detection varied significantly by age (26.8% for 0 to 5 months, 42.5% for 6 to 11 months and 52.1% for children aged 12 to 35 months; P < 0.001), and by season (51.2% in winter/spring vs. 24.5% in summer/autumn; P < 0.001). While those infected with rotavirus were more likely to be dehydrated (50.6% vs. 37.4%; P < 0.001), their median hospital stay was similar (1.0 vs. 2.0 days; P = 0.09) to other children with acute gastroenteritis. The estimated national hospitalisation rate for rotavirus diarrhoea in children under 3 years, standardised for age and season, was 634 (95% CI 597, 672) per 100,000. In New Zealand, rotaviruses result in 1 in 52 children being hospitalised by 3 years of age. CONCLUSIONS Rotavirus diarrhoea is an important, potentially vaccine-preventable cause of hospitalisation in New Zealand children, especially during winter and spring seasons.
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Affiliation(s)
- Keith Grimwood
- Department of Paediatrics and Child Health, Wellington School of Medicine and Health Sciences, University of Otago, New Zealand.
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