Loan, James JM, Bacon, Andrew, van Beijnum, Janneke, Bhatt, Pragnesh, Bjornson, Anna, Broomes, Nicole, Bullen, Alistair, Bulters, Diederik, Cahill, Julian, Chavredakis, Emmanuel et al (show 44 more authors)
(2023)
Feasibility of comparing medical management and surgery (with neurosurgery or stereotactic radiosurgery) with medical management alone in people with symptomatic brain cavernoma protocol for the Cavernomas: A Randomised Effectiveness (CARE) pilot trial.
BMJ OPEN, 13 (8).
e075187-.
Abstract
<h4>Introduction</h4>The top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was 'Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people diagnosed with a cavernoma?' This pilot randomised controlled trial (RCT) aims to determine the feasibility of answering this question in a main phase RCT.<h4>Methods and analysis</h4>We will perform a pilot phase, parallel group, pragmatic RCT involving approximately 60 children or adults with mental capacity, resident in the UK or Ireland, with an unresected symptomatic brain cavernoma. Participants will be randomised by web-based randomisation 1:1 to treatment with medical management and with surgery (neurosurgery or stereotactic radiosurgery) versus medical management alone, stratified by prerandomisation preference for type of surgery. In addition to 13 feasibility outcomes, the primary clinical outcome is symptomatic intracranial haemorrhage or new persistent/progressive focal neurological deficit measured at 6 monthly intervals. An integrated QuinteT Recruitment Intervention (QRI) evaluates screening logs, audio recordings of recruitment discussions, and interviews with recruiters and patients/parents/carers to identify and address barriers to participation. A Patient Advisory Group has codesigned the study and will oversee its progress.<h4>Ethics and dissemination</h4>This study was approved by the Yorkshire and The Humber-Leeds East Research Ethics Committee (21/YH/0046). We will submit manuscripts to peer-reviewed journals, describing the findings of the QRI and the Cavernomas: A Randomised Evaluation (CARE) pilot trial. We will present at national specialty meetings. We will disseminate a plain English summary of the findings of the CARE pilot trial to participants and public audiences with input from, and acknowledgement of, the Patient Advisory Group.<h4>Trial registration number</h4>ISRCTN41647111.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Adult neurology, Clinical Trial, Neurosurgery, NEUROSURGERY, Paediatric neurology, Stroke |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 31 Jan 2024 10:23 |
| Last Modified: | 31 Jan 2024 10:23 |
| DOI: | 10.1136/bmjopen-2023-075187 |
| Open Access URL: | https://bmjopen.bmj.com/content/13/8/e075187 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178169 |
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