TY - BOOK
T1 - Systematic review of interventions to increase
participation of cancer patients in randomised
controlled trials
AU - McDaid, C.
AU - Fayter, D.
AU - Eastwood, A.
AU - Hodges, Z.
AU - Stirk, L.
N1 - © 2006 Centre for Reviews and Dissemination, University of York. Available from the CRD web site.
PY - 2006/3
Y1 - 2006/3
N2 - Background
There are many barriers to patient participation in randomised controlled trials (RCTs) of
cancer treatments. To increase participation in trials, strategies need to be identified to
overcome these barriers. The National Cancer Research Network (NCRN) commissioned a
systematic review of the evidence-base for interventions to increase cancer patient
participation in trials.
Aim
To evaluate the effectiveness of interventions to overcome barriers to participation in RCTs
of cancer treatments.
Methods
Fifteen electronic databases including MEDLINE, EMBASE, PsycINFO, and System for
Information and Grey Literature in Europe, and Science and Social Science Citation Index
were searched from inception to January 2005 for published and unpublished studies in any
language. Bibliographies of potentially relevant articles were searched. Two reviewers
independently assessed titles and abstracts and also full papers where these were obtained.
Studies of any interventions to improve cancer patient participation in RCTs, which reported
participation rates, were eligible for inclusion. RCTs and non-RCTs as well as before and
after studies reporting baseline rates specific to the population being investigated were
included.
Data were extracted by one reviewer into structured summary tables and checked for
accuracy by a second reviewer. Each included study was assessed against a checklist for
methodological quality by one reviewer and checked by a second reviewer.
A narrative synthesis was conducted. Studies were grouped according to relevance to the
UK setting and within this by study design.
Results
Eight studies were identified that met the inclusion criteria: three RCTs, two non-RCTs and
three observational studies. Six of the studies had an intervention that had some relevance to
the UK. The majority of studies were concerned with some aspect of the consent process.
There was no evidence that any of the interventions investigated led to an increase in cancer
patient participation in RCTs, though one good quality RCT found that urologists and nurses
were equally effective at recruiting participants to a treatment trial for prostate cancer.
Although there was no evidence of an effect in any of the studies, the evidence was not of
sufficient quality to be able to conclude that these interventions therefore do not work. Overall,
the studies had a range of methodological weaknesses. In particular, in most of the studies
there was a risk of contamination between the experimental and comparison intervention
leading to a possible dilution of the effect of the experimental intervention.
Conclusions
There is not a strong evidence-base for interventions that increase cancer patient
participation in randomised trials. Further research is required to evaluate the effectiveness
of strategies to increase participation in cancer treatment trials.
AB - Background
There are many barriers to patient participation in randomised controlled trials (RCTs) of
cancer treatments. To increase participation in trials, strategies need to be identified to
overcome these barriers. The National Cancer Research Network (NCRN) commissioned a
systematic review of the evidence-base for interventions to increase cancer patient
participation in trials.
Aim
To evaluate the effectiveness of interventions to overcome barriers to participation in RCTs
of cancer treatments.
Methods
Fifteen electronic databases including MEDLINE, EMBASE, PsycINFO, and System for
Information and Grey Literature in Europe, and Science and Social Science Citation Index
were searched from inception to January 2005 for published and unpublished studies in any
language. Bibliographies of potentially relevant articles were searched. Two reviewers
independently assessed titles and abstracts and also full papers where these were obtained.
Studies of any interventions to improve cancer patient participation in RCTs, which reported
participation rates, were eligible for inclusion. RCTs and non-RCTs as well as before and
after studies reporting baseline rates specific to the population being investigated were
included.
Data were extracted by one reviewer into structured summary tables and checked for
accuracy by a second reviewer. Each included study was assessed against a checklist for
methodological quality by one reviewer and checked by a second reviewer.
A narrative synthesis was conducted. Studies were grouped according to relevance to the
UK setting and within this by study design.
Results
Eight studies were identified that met the inclusion criteria: three RCTs, two non-RCTs and
three observational studies. Six of the studies had an intervention that had some relevance to
the UK. The majority of studies were concerned with some aspect of the consent process.
There was no evidence that any of the interventions investigated led to an increase in cancer
patient participation in RCTs, though one good quality RCT found that urologists and nurses
were equally effective at recruiting participants to a treatment trial for prostate cancer.
Although there was no evidence of an effect in any of the studies, the evidence was not of
sufficient quality to be able to conclude that these interventions therefore do not work. Overall,
the studies had a range of methodological weaknesses. In particular, in most of the studies
there was a risk of contamination between the experimental and comparison intervention
leading to a possible dilution of the effect of the experimental intervention.
Conclusions
There is not a strong evidence-base for interventions that increase cancer patient
participation in randomised trials. Further research is required to evaluate the effectiveness
of strategies to increase participation in cancer treatment trials.
M3 - Commissioned report
SN - 1 900640 39 2
T3 - CRD Report
BT - Systematic review of interventions to increase
participation of cancer patients in randomised
controlled trials
PB - University of York
CY - York, UK
ER -