scholarly journals Effects of rapid recruitment and dissemination on Covid-19 mortality: the RECOVERY trial

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1017
Author(s):  
Catherine Knowlson ◽  
David J. Torgerson
Keyword(s):  
Randomised Controlled Trial ◽  
Prime Minister ◽  
Controlled Trial ◽  
Supplemental Oxygen ◽  
Site Specific ◽  
Hospitalised Patients ◽  
British Prime Minister ◽  
Randomised Controlled ◽  
The Uk

The RECOVERY trial is a large multi-armed, adaptive randomised controlled trial of treatments for Covid-19.  It has rapidly recruited and demonstrated that hydroxychloroquine is ineffective in reducing mortality for hospitalised patients, whilst dexamethasone significantly reduces mortality among those patients using supplemental oxygen or on a ventilator.  We estimate that the speed of recruitment and dissemination has probably decreased mortality in the UK by at least 200 hospitalised patients in the first month since the British Prime Minister announced the results.  Despite its impressive speed, the trial only recruited about 15% of eligible patients, with recruitment rates ranging between 3% to 80% at participating hospitals.  Had the trial recruited 50% of the eligible patients then our analysis suggests that more than 2,000 additional lives could have been saved.  In a pandemic, rapid recruitment with high centre recruitment is absolutely essential to reduce deaths.  Methods of improving site specific recruitment rates need investigating urgently.

scholarly journals Effects of rapid recruitment and dissemination on Covid-19 mortality: the RECOVERY trial

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1017
Author(s):  
Catherine Knowlson ◽  
David J. Torgerson
Keyword(s):  
Randomised Controlled Trial ◽  
Prime Minister ◽  
Controlled Trial ◽  
Supplemental Oxygen ◽  
Site Specific ◽  
Hospitalised Patients ◽  
British Prime Minister ◽  
Randomised Controlled ◽  
The Uk

The RECOVERY trial is a large multi-armed, adaptive randomised controlled trial of treatments for Covid-19.  It has rapidly recruited and demonstrated that hydroxychloroquine is ineffective in reducing mortality for hospitalised patients, whilst dexamethasone significantly reduces mortality among those patients using supplemental oxygen or on a ventilator.  We estimate that the speed of recruitment and dissemination has probably decreased mortality in the UK by at least 200 hospitalised patients in the first month since the British Prime Minister announced the results.  Despite its impressive speed, the trial only recruited about 10-15% of eligible patients, with recruitment rates ranging between 3% to 80% at participating hospitals.  Had the trial recruited 50% of the eligible patients then our analysis suggests that more than 2,000 additional lives could have been saved.  In a pandemic, rapid recruitment with high centre recruitment is absolutely essential to reduce deaths.  Methods of improving site specific recruitment rates need investigating urgently.

Protocol for a feasibility randomised controlled trial comparing cognitive functional therapy with usual physiotherapy care in people with persistent low back pain

2021 ◽  
pp. 1-14
Author(s):  
Christopher Newton ◽  
Gurpreet Singh ◽  
David Nolan ◽  
Vicky Booth ◽  
Claire Diver ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Low Back ◽  
Functional Therapy ◽  
Randomised Controlled ◽  
The Uk ◽  
Feasibility Rct

BACKGROUND: Combined physical and psychological programmes (CPPP) are recommended for people with disabling low back pain (LBP). Cognitive Functional Therapy (CFT) is a physiotherapist-led low intensity CPPP with positive effects in previous studies. The clinical and cost effectiveness of CFT has not previously been evaluated in a randomised controlled trial (RCT) in the United Kingdom (UK) National Health Service (NHS). Before a definitive RCT can be completed it is necessary to determine if completing such a study is possible. PURPOSE: To determine the feasibility of completing a definitive RCT, that will evaluate the clinical and cost-effectiveness of CFT in comparison to usual physiotherapy care for people with persistent LBP in the UK NHS. METHODS: A pragmatic two-arm parallel feasibility RCT comparing CFT with usual physiotherapy care for people with persistent LBP will be completed. Sixty participants will be randomly allocated to receive CFT or usual physiotherapy care. The primary outcome will be feasibility of completing a definitive RCT. Participant reported outcome measures will be recorded at baseline, three, six and twelve-month follow-up, including disability, pain intensity, quality of life and psychosocial function. Data will be analysed descriptively. A qualitative process evaluation will explore the acceptability of the research processes and interventions. DISCUSSION: The rationale and methodological design of a mixed methods feasibility RCT is presented. This study aims to inform the planning, design and completion of a future definitive RCT in the UK NHS. The results will be disseminated through peer reviewed open access journal publication.

scholarly journals Using routinely recorded data in the UK to assess outcomes in a randomised controlled trial: The Trials of Access

Trials ◽  
2017 ◽  
Vol 18 (1) ◽  
Author(s):  
G. A. Powell ◽  
L. J. Bonnett ◽  
C. Tudur-Smith ◽  
D. A. Hughes ◽  
P. R. Williamson ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Recorded Data ◽  
Randomised Controlled ◽  
The Uk

scholarly journals Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation

Thorax ◽  
2018 ◽  
Vol 73 (8) ◽  
pp. 713-722 ◽  
Author(s):  
Carlos Echevarria ◽  
Joanne Gray ◽  
Tom Hartley ◽  
John Steer ◽  
Jonathan Miller ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Length Of Stay ◽  
Controlled Trial ◽  
Prognostic Score ◽  
Cost Effective ◽  
Low Risk ◽  
Copd Exacerbation ◽  
Hospitalised Patients ◽  
Life Years ◽  
Randomised Controlled

BackgroundPrevious models of Hospital at Home (HAH) for COPD exacerbation (ECOPD) were limited by the lack of a reliable prognostic score to guide patient selection. Approximately 50% of hospitalised patients have a low mortality risk by DECAF, thus are potentially suitable.MethodsIn a non-inferiority randomised controlled trial, 118 patients admitted with a low-risk ECOPD (DECAF 0 or 1) were recruited to HAH or usual care (UC). The primary outcome was health and social costs at 90 days.ResultsMean 90-day costs were £1016 lower in HAH, but the one-sided 95% CI crossed the non-inferiority limit of £150 (CI −2343 to 312). Savings were primarily due to reduced hospital bed days: HAH=1 (IQR 1–7), UC=5 (IQR 2–12) (P=0.001). Length of stay during the index admission in UC was only 3 days, which was 2 days shorter than expected. Based on quality-adjusted life years, the probability of HAH being cost-effective was 90%. There was one death within 90 days in each arm, readmission rates were similar and 90% of patients preferred HAH for subsequent ECOPD.ConclusionHAH selected by low-risk DECAF score was safe, clinically effective, cost-effective, and preferred by most patients. Compared with earlier models, selection is simpler and approximately twice as many patients are eligible. The introduction of DECAF was associated with a fall in UC length of stay without adverse outcome, supporting use of DECAF to direct early discharge.Trial registration numberRegistered prospectively ISRCTN29082260.

Sign in / Sign up

Export Citation Format

Share Document