Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies

Avery, Kerry NL, Williamson, Paula R ORCID: 0000-0001-9802-6636, Gamble, Carrol ORCID: 0000-0002-3021-1955, Francischetto, Elaine O'Connell, Metcalfe, Chris, Davidson, Peter, Williams, Hywel and Blazeby, Jane M (2017) Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies. BMJ OPEN, 7 (2). e013537-.

Text Avery_manuscript_19.12.16_v7_UNLINKED CITATIONS_REVISION_CLEAN.docx - Author Accepted Manuscript Download (64kB)

Abstract

<h4>Objectives</h4>Designing studies with an internal pilot phase may optimise the use of pilot work to inform more efficient randomised controlled trials (RCTs). Careful selection of preagreed decision or 'progression' criteria at the juncture between the internal pilot and main trial phases provides a valuable opportunity to evaluate the likely success of the main trial and optimise its design or, if necessary, to make the decision not to proceed with the main trial. Guidance on the appropriate selection and application of progression criteria is, however, lacking. This paper outlines the key issues to consider in the optimal development and review of operational progression criteria for RCTs with an internal pilot phase.<h4>Design</h4>A structured literature review and exploration of stakeholders' opinions at a Medical Research Council (MRC) Hubs for Trials Methodology Research workshop. Key stakeholders included triallists, methodologists, statisticians and funders.<h4>Results</h4>There is considerable variation in the use of progression criteria for RCTs with an internal pilot phase, although 3 common issues predominate: trial recruitment, protocol adherence and outcome data. Detailed and systematic reporting around the decision-making process for stopping, amending or proceeding to a main trial is uncommon, which may hamper understanding in the research community about the appropriate and optimal use of RCTs with an internal pilot phase. 10 top tips for the development, use and reporting of progression criteria for internal pilot studies are presented.<h4>Conclusions</h4>Systematic and transparent reporting of the design, results and evaluation of internal pilot trials in the literature should be encouraged in order to facilitate understanding in the research community and to inform future trials.

Item Type:	Article
Uncontrolled Keywords:	members of the Internal Pilot Trials Workshop supported by the Hubs for Trials Methodology Research, Humans, Clinical Protocols, Pilot Projects, Attitude, Decision Making, Research Design, Patient Selection, Research Personnel, Guideline Adherence, Clinical Trials Data Monitoring Committees, Randomized Controlled Trials as Topic, Research Report, Outcome Assessment, Health Care
Depositing User:	Symplectic Admin
Date Deposited:	07 Mar 2017 07:33
Last Modified:	19 Jan 2023 07:14
DOI:	10.1136/bmjopen-2016-013537
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3006227