Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).

Clinical trials require cost-effective methods for identifying, randomising, and following large numbers of people in order to generate reliable evidence. ASCEND (A Study of Cardiovascular Events iN Diabetes) is a randomised '2 × 2 factorial design' study of aspirin and omega-3 fatty acid...

Full description

Bibliographic Details
Main Authors: Aung, T, Haynes, R, Barton, J, Cox, J, Murawska, A, Murphy, K, Lay, M, Armitage, J, Bowman, L, ASCEND Study Collaborative Group
Format: Journal article
Language:English
Published: BioMed Central 2016
_version_ 1797106195029295104
author Aung, T
Haynes, R
Barton, J
Cox, J
Murawska, A
Murphy, K
Lay, M
Armitage, J
Bowman, L
ASCEND Study Collaborative Group
author_facet Aung, T
Haynes, R
Barton, J
Cox, J
Murawska, A
Murphy, K
Lay, M
Armitage, J
Bowman, L
ASCEND Study Collaborative Group
author_sort Aung, T
collection OXFORD
description Clinical trials require cost-effective methods for identifying, randomising, and following large numbers of people in order to generate reliable evidence. ASCEND (A Study of Cardiovascular Events iN Diabetes) is a randomised '2 × 2 factorial design' study of aspirin and omega-3 fatty acid supplements for the primary prevention of cardiovascular events in people with diabetes; this study used central disease registers and a mail-based approach to identify, randomise, and follow 15,000 people. In collaboration with UK consultants and general practitioners (GPs), researchers identified potentially eligible people with diabetes from centrally held registers (e.g. for retinopathy screening) and GP-held disease registers. Permission was obtained under section 251 of the National Health Service Act 2006 (previously section 60 of the NHS act 2001) to allow invitation letters to be generated centrally in the name of the holder of the register. In addition, with the collaboration of the National Institutes for Health Research (NIHR) Diabetes and Primary Care Research Networks (DRN and PCRN), general practices sent pre-assembled invitation packs to people with a diagnosis of diabetes. Invitation packs included a cover letter, screening questionnaire (with consent form), information leaflet, and a Freepost envelope. Eligible patients entered a 2-month, pre-randomisation, run-in phase on placebo tablets and were only randomised if they completed a randomisation form and remained willing and eligible at the end of the run-in. Follow-up is ongoing, using mail-based approaches that are being supplemented by central registry data.Information on approximately 600,000 people listed on 58 centrally held diabetes registers was obtained, and 300,188 potentially eligible patients were invited to join the study. In addition, 785 GP practices mailed invitations to 120,875 patients. A further 2,340 potential study participants were identified via other routes. In total, 423,403 people with diabetes were invited to take part; 26,462 entered the 2-month, pre-randomisation, run-in phase; and 15,480 were randomised.If sufficient numbers of potentially eligible patients can be identified centrally and the trial treatments do not require participants to attend clinics, the recruitment and follow-up of patients by mail is feasible and cost-effective. Wider use of these methods could allow more, large, randomised trials to be undertaken successfully and cost-effectively.Current Controlled Trials, ISRCTN60635500 , registered on 14 July 2005.
first_indexed 2024-03-07T06:58:17Z
format Journal article
id oxford-uuid:fee1d4de-3840-42d5-94fe-d43139bfcf76
institution University of Oxford
language English
last_indexed 2024-03-07T06:58:17Z
publishDate 2016
publisher BioMed Central
record_format dspace
spelling oxford-uuid:fee1d4de-3840-42d5-94fe-d43139bfcf762022-03-27T13:40:13ZCost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fee1d4de-3840-42d5-94fe-d43139bfcf76EnglishSymplectic Elements at OxfordBioMed Central2016Aung, THaynes, RBarton, JCox, JMurawska, AMurphy, KLay, MArmitage, JBowman, LASCEND Study Collaborative GroupClinical trials require cost-effective methods for identifying, randomising, and following large numbers of people in order to generate reliable evidence. ASCEND (A Study of Cardiovascular Events iN Diabetes) is a randomised '2 × 2 factorial design' study of aspirin and omega-3 fatty acid supplements for the primary prevention of cardiovascular events in people with diabetes; this study used central disease registers and a mail-based approach to identify, randomise, and follow 15,000 people. In collaboration with UK consultants and general practitioners (GPs), researchers identified potentially eligible people with diabetes from centrally held registers (e.g. for retinopathy screening) and GP-held disease registers. Permission was obtained under section 251 of the National Health Service Act 2006 (previously section 60 of the NHS act 2001) to allow invitation letters to be generated centrally in the name of the holder of the register. In addition, with the collaboration of the National Institutes for Health Research (NIHR) Diabetes and Primary Care Research Networks (DRN and PCRN), general practices sent pre-assembled invitation packs to people with a diagnosis of diabetes. Invitation packs included a cover letter, screening questionnaire (with consent form), information leaflet, and a Freepost envelope. Eligible patients entered a 2-month, pre-randomisation, run-in phase on placebo tablets and were only randomised if they completed a randomisation form and remained willing and eligible at the end of the run-in. Follow-up is ongoing, using mail-based approaches that are being supplemented by central registry data.Information on approximately 600,000 people listed on 58 centrally held diabetes registers was obtained, and 300,188 potentially eligible patients were invited to join the study. In addition, 785 GP practices mailed invitations to 120,875 patients. A further 2,340 potential study participants were identified via other routes. In total, 423,403 people with diabetes were invited to take part; 26,462 entered the 2-month, pre-randomisation, run-in phase; and 15,480 were randomised.If sufficient numbers of potentially eligible patients can be identified centrally and the trial treatments do not require participants to attend clinics, the recruitment and follow-up of patients by mail is feasible and cost-effective. Wider use of these methods could allow more, large, randomised trials to be undertaken successfully and cost-effectively.Current Controlled Trials, ISRCTN60635500 , registered on 14 July 2005.
spellingShingle Aung, T
Haynes, R
Barton, J
Cox, J
Murawska, A
Murphy, K
Lay, M
Armitage, J
Bowman, L
ASCEND Study Collaborative Group
Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).
title Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).
title_full Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).
title_fullStr Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).
title_full_unstemmed Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).
title_short Cost-effective recruitment methods for a large randomised trial in people with diabetes: A Study of Cardiovascular Events iN Diabetes (ASCEND).
title_sort cost effective recruitment methods for a large randomised trial in people with diabetes a study of cardiovascular events in diabetes ascend
work_keys_str_mv AT aungt costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT haynesr costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT bartonj costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT coxj costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT murawskaa costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT murphyk costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT laym costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT armitagej costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT bowmanl costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend
AT ascendstudycollaborativegroup costeffectiverecruitmentmethodsforalargerandomisedtrialinpeoplewithdiabetesastudyofcardiovasculareventsindiabetesascend