The Medical Research Council (MRC) has a number of ‘Hubs’ across various cities in the UK, each conducting research into different aspects of clinical trials methodology. Together, the Hubs are known as the HTMR Network – the Hubs for Trials Methodology Research Network. As part of these hubs, there are a number of Working Groups. These Working Groups each focus on a specific area of interest in the trials methodology world.
I’m part of the Recruitment Working Group, and a few weeks ago we had a face to face meeting in Liverpool. Usually we have monthly teleconferences to ensure that we all know what projects are ongoing, and there are distinct pieces of work being done by groups of people within the group too. Until now I hadn’t met many of the group members face to face, so this was a brilliant opportunity for us to work together and make decisions on where we wanted to go next in terms of projects, funding and potential collaborators.
The meeting was incredibly productive, and I came away inspired and exciting for the work we’ll do together in the future – on a side note, if you’re ever feeling uninspired by your research, make an effort to go to a conference, symposium, or big meeting with people that have similar research interests to you; I always come away feeling enthusiastic and ready to work!
Anyway, when I got back I flicked through my notes and came up with an infographic that covers (in brief!) lots of what we talked about:
I thought I’d give an outline of what this infographic shows, and when paper(s) eventually start to come out, I’ll update this blog and explain a bit more about the specifics of the research too.
Online Resource for Recruitment research in clinical Trials (ORRCA) is one of the Recruitment Working Group’s biggest success stories. Carrol Gamble gave a short presentationon ORRCA, explaining that it was a huge project made possible by many of the members of the group giving up there time to screen abstracts and categorise studies so that the database could be populated.I was one of the people who categorised papers etc, and I’ll be a named author on the paper when it comes out, so I’ll do another blog post with more details then. In brief – ORRCA is a database full of recruitment research, it is updated every year and means that recruitment researchers can use it as a one stop shop for relevant literature. This is incredibly useful because when you’re doing a systematic review you inevitably end up screening through hundreds, if not thousands, of irrelevant literature. Using the ORRCA database means that a lot of the irrelevant studies have already been weeded out, so the entire process of doing a systematic review could be sped up hugely.
The Cochrane Recruitment Review
Taken from Wikipedia: The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the results of medical research. The Cochrane Library aims to make the results of well-conducted controlled trials readily available and is a key resource in evidence-based medicine.
My PhD Supervisor has a Cochrane systematic review that looks at strategies to improve recruitment to clinical trials. The review was published in 2010, and is now in the process of being updated; it’s important that systematic reviews are updated so that we can hoover up and include data from recent studies. The short talk that Shaun gave focussed on the results of the update (it’s currently under review and should hopefully be published soon – and I’m a named author, hoorah!). Largely, the information that we have about recruitment strategies is thin, that was the case in 2010 and it’s still the case now. There’s one notable exception though – the MRC START project. MRC START was a project that offered something that we so often lack in the world of recruitment research; coordination. I’m not going to go into too much detail here, I’ll just say that when a coordinated effort focusses on answering a research question, that research question is much more likely to be answered with a satisfactory body of evidence. The updated review doesn’t provide us with groundbreaking results, but it does provide encouragement – we are seeing slow progress in the world of methodology research, and that’s better than no progress at all!
The Non-Randomised Recruitment Review
After Shaun had given his presentation on the Cochrane review, I then gave a short presentation on the systematic review that I lead. This review makes up a substantial part of my PhD project; the protocol for it was published last year. This review differs from the Cochrane review in that it includes only non-randomised studies, i.e. a bigger body of evidence, that is of a much lower quality. I’m planning on doing a more detailed blog post about this review when it is published, so keep an eye out for that – hopefully next Spring.
I don’t want to give too much away about the PRioRiTy project because I know that the paper from it has just been submitted, so again, I’ll do a more detailed blog post when it’s out. The basic outline of PRioRiTy is a priority setting project in partnership with the James Lind Alliance.
The James Lind Alliance believes that:
- addressing uncertainties about the effects of a treatment should become accepted as a routine part of clinical practice
- patients, carers and clinicians should work together to agree which, among those uncertainties, matter most and deserve priority attention.
They usually get involved with prioritisation work around clinical outcomes, but this was their first methodology-based project, so very exciting! The project involved lots of different stakeholders, with the aim of coming up with a prioritised list of topics for research within the area of trials recruitment. Declan Devane explained how the project progressed, and then unveiled the top 10 questions that came out of the work. This work provides a point of focus for us as recruitment researchers. As I mentioned earlier, the concept of coordinated effort is something we’ve lacked, meaning that a lot of work is happening in a lot of different areas, but the effort involved isn’t particularly focussed.
The meeting was super productive, and we’re planning another face to face meeting for the early part of 2018 so that we can work up some of the ideas that we came up with in that meeting. Ultimately, we want to have a few well thought-out project ideas, so that we can start looking at potential pots of funding for the collaborative work we’ve planned.