Recruitment issues when primary care population clusters are used in randomised controlled clinical trials: Climbing mountains or pushing boulders uphill?
ABSTRACT Cluster randomised controlled trials for health promotion, education, public health or organisational change interventions are becoming increasingly common to inform evidence-based policy. However, there is little published methodological evidence on recruitment strategies for primary care population clusters. In this paper, we discuss how choosing which population cluster to randomise can impact on the practicalities of recruitment in primary care. We describe strategies developed through our experiences of recruiting primary care organisations to participate in a national randomised controlled trial of a policy to provide community breastfeeding groups for pregnant and breastfeeding mothers, the BIG (Breastfeeding in Groups) trial. We propose an iterative qualitative approach to recruitment; collecting data generated through the recruitment process, identifying themes and using the constant comparative method of analysis. This can assist in developing successful recruitment strategies and contrasts with the standardised approach commonly used when recruiting individuals to participate in randomised controlled trials. Recruiting primary care population clusters to participate in trials is currently an uphill battle in Britain. It is a complex process, which can benefit from applying qualitative methods to inform trial design and recruitment strategy. Recruitment could be facilitated if health service managers were committed to supporting peer reviewed, funded and ethics committee approved research at national level.
- SourceAvailable from: Kevin D O'Brien
Dataset: In search of the sample
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ABSTRACT: Our objectives were to evaluate the evidence with regard to the effectiveness and stability of orthodontic treatment interventions for Class II Division 2 malocclusion in children and adolescents. This is a systematic review conducted according to the PRISMA statement. The Cochrane Oral Health Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched to November 2011. Relevant conference abstracts were also screened. No language restrictions were applied. Inclusion criteria were clinical studies with at least 20 subjects with Class II Division 2 malocclusion in which comparisons were made with an untreated Class II Division 2 malocclusion group, another treated Class II Division 2 malocclusion group, or neither. For included studies ranked best on the hierarchy of evidence, assessments of methodologic quality and risk of bias were undertaken. Abstracts and, when appropriate, full articles were examined independently by 2 investigators. Disagreements were resolved through discussion. Treatment changes and stability with or without retainers were measured with the following: skeletal, soft tissue, dental, and occlusal changes; gingival health; temporomandibular joint status and related muscular activity; and quality of life. Of the 322 studies identified in the search, 20 met the final inclusion criteria. All had a high risk of bias. Highly biased evidence exists with regard to management and stability of Class II Division 2 malocclusion. Guidelines are proposed based on current evidence.American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 08/2012; 142(2):159-169.e9. DOI:10.1016/j.ajodo.2012.03.022 · 1.44 Impact Factor
Conference Paper: Error bounds for estimating bandpassed FM signals[Show abstract] [Hide abstract]
ABSTRACT: Presented here are general limits on bandpass filter performance as a denoising step for parameter estimation. Monocomponent analytic FM signals in white Gaussian noise are assumed. Analytic and numerical evidence is presented to support the argument that the Gaussian filter can be used as a canonical bandpass filter for the purpose of such an analysis. Simple, approximate Cramer-Rao bound formulas for amplitude, phase and IF estimates are presented for limiting cases.Signals, Systems and Computers, 2002. Conference Record of the Thirty-Sixth Asilomar Conference on; 12/2002