Evidence map›Paper›PMID 26683473›Full record

Trial reportBMC research notes2015

Challenges of a community based pragmatic, randomised controlled trial of weight loss maintenance.

Elizabeth Randell, Rachel McNamara, Christine Shaw, Aude Espinasse, Sharon Anne Simpson

Abstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in BMC research notes, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elizabeth RandellSouth East Wales Trials Unit, Heath Park, Cardiff University, Cardiff, Wales, UK. randelle@cardiff.ac.uk.
Rachel McNamaraSouth East Wales Trials Unit, Heath Park, Cardiff University, Cardiff, Wales, UK. mcnamara@cardiff.ac.uk.
Christine ShawSouth East Wales Trials Unit, Heath Park, Cardiff University, Cardiff, Wales, UK. chris.shaw@southwales.ac.uk.
Aude EspinasseSouth East Wales Trials Unit, Heath Park, Cardiff University, Cardiff, Wales, UK. espinassesam@cardiff.ac.uk.
Sharon Anne SimpsonMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, Scotland, UK. sharon.simpson@glasgow.ac.uk.

Funding

Department of Health 08/44/04Medical Research Council MC_PC_13027Medical Research Council MC_UU_12017/14
6 · The paper itself

Abstract

backgroundRandomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions.

methodsThe weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)-GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment.

resultsDelays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately.

conclusionsLearnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of any community-based complex intervention is paramount. The appropriateness and viability of inclusion criteria also require careful consideration as does use of a targeted advertising strategy.

trial registrationISRCTN35774128, 12/01/2010.

Indexed as

Outcome and Process Assessment, Health CarePatient SelectionWeight LossAdolescentAdultAgedCommunity Health ServicesEnglandFemaleHumansMaleMiddle AgedNational Health ProgramsPragmatic Clinical Trials as TopicResearch DesignYoung Adult

Identifiers

PMID26683473
PMCPMC4684604

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.