Routinely embedding recruitment and retention interventions within randomised controlled trials

有必要通过开发和试验新的治疗方法来改善卫生保健和福祉。测试这些新疗法的最佳方法是使用随机对照试验（RCT）。在一项随机对照试验中，一些患者接受了新的治疗，而另一些则没有。然后比较不同组的结果，看看治疗是否会带来更好的健康。许多类似的试验都在英国国民医疗服务体系中进行，但招募患者并让他们参与这些试验通常非常困难，而且需要比计划更长的时间。用于接近患者的方法通常没有经过测试，看它们是否有效，这意味着研究团队不知道如何最好地招募和保持患者的参与。正因为如此，研究经常被推迟，患者和专业人员无法从了解哪种治疗方法最有效中获益。最近，人们对测试不同的招募和保持患者参与英国国家医疗服务体系随机对照试验的方法很感兴趣。测试是在更大的随机对照试验中进行的。这些研究被称为“试验研究”或swat。医学研究委员会之前资助了我们研究小组的成员，以研究是否有可能同时在一系列不同的试验中进行swat，并设计进行这些试验的标准。有了这笔资金，我们就能够设计执行和报告swat的框架和标准。最近建立了一个特警队的数据库。其他研究人员可以使用这个数据库来分享他们对swat的想法，并鼓励其他人进行这类研究，以便将来将这些发现结合起来，形成更好的证据来证明什么是有效的。我们的目标是在早期工作的基础上，通过使swat成为临床试验单位的标准实践，这些临床试验单位是英国进行随机对照试验的主要中心。我们希望为至少25个特警队提供支持，为特警队提供建议，并提供5000英镑的财政支持，以支付每个特警队的费用。我们已经建立了一个临床试验单位网络，这些单位承诺启动至少两个swat，重点是招募和保持患者参与。最终目标是使swat在临床试验中成为常规。这将有助于NHS进行更好的研究，从而了解如何改善患者的健康和福祉。

There is a need to improve health care and wellbeing by developing and testing new treatments. The best way to test these new treatments is using a randomised controlled trial (RCT). In a RCT some patients get the new treatment and some do not. The results of the different groups are then compared to see if the treatment leads to better health. Many trials like this are run in the NHS but recruiting patients and keeping them engaged in these trials is often very difficult and takes longer than planned. The methods used to approach people generally have not been tested to see if they work, meaning research teams don't know how best to recruit and keep patients engaged. Because of this, research is often delayed and patients and professionals cannot benefit from knowing which treatments work best.Recently, there has been an interest in testing different ways of recruiting and keeping patients engaged in RCTs that are taking place in the NHS. The testing is done in studies set within a larger RCT. These studies are called 'Studies Within A Trial' or SWATs. The Medical Research Council previously funded members of our research team to find out whether it was possible to do SWATs across a range of different trials at the same time, and to design standards for doing them. With this funding we were able to design frameworks and standards for doing and reporting SWATs. Recently a database of SWATs has been set up. This database can be used by other researchers to share their ideas for SWATs and to encourage others to do these types of studies, so that findings might in future be combined to develop better evidence of what works. Our aim is to build on this earlier work by making SWATs standard practice across Clinical Trials Units, which are the leading centres for doing RCTs in the UK. We would like to support at least 25 SWATs, by giving teams doing SWATs advice and financial support of £5000 to cover the costs of doing each SWAT. We have set up a network of Clinical Trials Units who have committed to starting at least two SWATs that are focused on recruiting and keeping patients engaged. The ultimate aim is to make SWATs routine when doing a clinical trial. This will help the NHS to do better research which will lead to knowledge of how to improve the health and well-being of patients.