Evidence map›Paper›PMID 29273060›Full record

ArticleTrials2017

'We all want to succeed, but we've also got to be realistic about what is happening': an ethnographic study of relationships in trial oversight and their impact.

Anne Daykin, Lucy E Selman, Helen Cramer, Sharon McCann, Gillian W Shorter, Matthew R Sydes, Carrol Gamble, Rhiannon Macefield, J Athene Lane, Alison Shaw

Abstract read
In one paragraph

Article in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. 'A limpet on a ship': Spatio-temporal dynamics of patient and public involvement in research.Health expectations : an international journal of public participation in health care and health policy · 2021
    Article
  3. Article
  4. 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

10 authors.

Anne DaykinMRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK. anne.daykin@bristol.ac.uk.
Lucy E SelmanMRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0001-5747-2699
Helen CramerMRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK.
Sharon McCannFormerly: Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
Gillian W ShorterPsychotraumatology, Mental Health and Suicidal Behaviour, Psychology Research Institute, Ulster University, Belfast, UK.
Matthew R SydesMRC Clinical Trials Unit at UCL, London, UK.
Carrol GambleMRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Rhiannon MacefieldMRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK.
J Athene LaneMRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK.
Alison ShawMRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK.

Funding

Medical Research Council G0800800Medical Research Council G0901530Medical Research Council MC_EX_UU_G0800814Medical Research Council MC_UU_12023/24Medical Research Council MR/K025635/1Medical Research Council MR/K025643/1Medical Research Council MR/L004933/1Medical Research Council MR/L004933/1- R34Medical Research Council MR/L004933/2
6 · The paper itself

Abstract

backgroundThe oversight and conduct of a randomised controlled trial involves several stakeholders, including a Trial Steering Committee (TSC), Trial Management Group (TMG), Data Monitoring Committee (DMC), funder and sponsor. We aimed to examine how the relationships between these stakeholders affect the trial oversight process and its rigour, to inform future revision of Good Clinical Practice guidelines.

methodsUsing an ethnographic study design, we observed the oversight processes of eight trials and conducted semi-structured interviews with members of the trials' TSCs and TMGs, plus other relevant informants, including sponsors and funders of trials. Data were analysed thematically, and findings triangulated and integrated to give a multi-perspective account of current oversight practices in the UK.

resultsEight TSC and six TMG meetings from eight trials were observed and audio-recorded, and 66 semi-structured interviews conducted with 52 purposively sampled key informants. Five themes are presented: (1) Collaboration within the TMG and role of the CTU; (2) Collaboration and conflict between oversight committees; (3) Priorities; (4) Communication between trial oversight groups and (5) Power and accountability. There was evidence of collaborative relationships, based on mutual respect, between CTUs, TMGs and TSCs, but also evidence of conflict. Relationships between trial oversight committees were influenced by stakeholders' priorities, both organisational and individual. Good communication following specific, recognised routes played a central role in ensuring that relationships were productive and trial oversight efficient. Participants described the possession of power over trials as a shifting political landscape, and there was lack of clarity regarding the roles and accountability of each committee, the sponsor and funder. Stakeholders' perceptions of their own power over a trial, and the power of others, influenced relationships between those involved in trial oversight.

conclusionsRecent developments in trial design and conduct have been accompanied by changes in roles and relationships between trial oversight groups. Recognising and respecting the value of differing priorities among those involved in running trials is key to successful relationships between committees, funders and sponsors. Clarity regarding appropriate lines of communication, roles and accountability is needed. We present 10 evidence-based recommendations to inform updates to international trial guidance, particularly the Medical Research Council guidelines.

Indexed as

Anthropology, CulturalResearch DesignClinical Trials Data Monitoring CommitteesCommunicationCross-Sectional StudiesFemaleHumansIntersectoral CollaborationMaleRandomized Controlled Trials as TopicEthnographyQualitative researchRandomised controlled trialsTrial managementTrial oversightTrial steering committee

Identifiers

PMID29273060
PMCPMC5741863

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.