How achievable are COVID-19 clinical trial recruitment targets? A UK observational cohort study and trials registry analysis
Autor: | Li Su, Simon J Gunter, Effrossyni Gkrania-Klotsas, Kelly Leonard, Nicholas J Matheson, Darrel P. Francis, Mark Yates, Jane Greenaway, Anthony De Soyza, M. E. Török, Mark Toshner, Prapa Kanagaratnam, Ben Prudon, Ben Warne, George Katritsis, Grant D. Stewart, Michael Brown, Nick G Cunniffe, Zoe McIntyre, James Galloway, Sarah W. Burge, Tommy Rampling, Sofia S. Villar, Hanif Esmail, Clare Coyle, Jacqui Galloway, Tom Dymond, Martin D Knolle |
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Přispěvatelé: | Cunniffe, Nick G [0000-0002-7562-2838], Gunter, Simon J [0000-0001-7125-9296], Galloway, James B [0000-0002-1230-2781], Torok, Mili Estee [0000-0001-9098-8590], Stewart, Grant D [0000-0003-3188-9140], Apollo - University of Cambridge Repository |
Rok vydání: | 2020 |
Předmět: |
Male
2019-20 coronavirus outbreak Biomedical Research Coronavirus disease 2019 (COVID-19) Pneumonia Viral Library science Eligibility Determination Health Services Accessibility Betacoronavirus Medicine Humans Prospective Studies Registries Pandemics Randomized Controlled Trials as Topic clinical trials Clinician scientist business.industry SARS-CoV-2 Patient Selection COVID-19 General Medicine Middle Aged University hospital United Kingdom Clinical trial Hospitalization Research centre Infectious diseases Female business Coronavirus Infections Cohort study |
Zdroj: | BMJ Open BMJ Open, Vol 10, Iss 10 (2020) |
Popis: | ObjectivesTo analyse enrolment to interventional trials during the first wave of the COVID-19 pandemic in England and describe the barriers to successful recruitment in the circumstance of a further wave or future pandemics.DesignWe analysed registered interventional COVID-19 trial data and concurrently did a prospective observational study of hospitalised patients with COVID-19 who were being assessed for eligibility to one of the RECOVERY, C19-ACS or SIMPLE trials.SettingInterventional COVID-19 trial data were analysed from the clinicaltrials.gov and International Standard Randomized Controlled Trial Number databases on 12 July 2020. The patient cohort was taken from five centres in a respiratory National Institute for Health Research network. Population and modelling data were taken from published reports from the UK government and Medical Research Council Biostatistics Unit.Participants2082 consecutive admitted patients with laboratory-confirmed SARS-CoV-2 infection from 27 March 2020 were included.Main outcome measuresProportions enrolled, and reasons for exclusion from the aforementioned trials. Comparisons of trial recruitment targets with estimated feasible recruitment numbers.ResultsAnalysis of trial registration data for COVID-19 treatment studies enrolling in England showed that by 12 July 2020, 29 142 participants were needed. In the observational study, 430 (20.7%) proceeded to randomisation. 82 (3.9%) declined participation, 699 (33.6%) were excluded on clinical grounds, 363 (17.4%) were medically fit for discharge and 153 (7.3%) were receiving palliative care. With 111 037 people hospitalised with COVID-19 in England by 12 July 2020, we determine that 22 985 people were potentially suitable for trial enrolment. We estimate a UK hospitalisation rate of 2.38%, and that another 1.25 million infections would be required to meet recruitment targets of ongoing trials.ConclusionsFeasible recruitment rates, study design and proliferation of trials can limit the number, and size, that will successfully complete recruitment. We consider that fewer, more appropriately designed trials, prioritising cooperation between centres would maximise productivity in a further wave. |
Databáze: | OpenAIRE |
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