Evidence map›Paper›PMID 36271441›Full record

ArticleTrials2022

WILL (When to Induce Labour to Limit risk in pregnancy hypertension): a multicentre randomised controlled trial - adaptations to deliver a timing-of-birth trial during the COVID-19 international pandemic.

Laura A Magee, Sue Tohill, Katie Kirkham, Ruth Evans, Eleni Gkini, Catherine A Moakes, Clive Stubbs, Jim Thornton, Peter von Dadelszen, WILL Trial Study Group

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Observational
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.

Laura A MageeInstitute of Women and Children's Health, King's College London, 5thFloor, Addison House, Guy's Campus, London, SE1 1UL, UK. laura.a.magee@kcl.ac.uk.ORCID http://orcid.org/0000-0002-1355-610X
Sue TohillMaternity Services, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Katie KirkhamBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Ruth EvansBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Eleni GkiniBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Catherine A MoakesBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Clive StubbsBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Jim ThorntonDepartment of Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK.
Peter von DadelszenInstitute of Women and Children's Health, King's College London, 5thFloor, Addison House, Guy's Campus, London, SE1 1UL, UK.
WILL Trial Study Group

Funding

Health Technology Assessment Programme 16/167/123
6 · The paper itself

Abstract

backgroundAs a pragmatic randomised timing-of-birth trial, WILL adapted its trial procedures in response to the COVID-19 pandemic. These are reviewed here to inform post-pandemic trial methodology.

methodsThe trial (internal pilot) paused in March 2020, re-opened in July 2020, and is currently recruiting in 37 UK NHS consultant-led maternity units. We evaluated pandemic adaptations made to WILL processes and surveyed sites for their views of these changes (20 sites, videoconference).

resultsDespite 88% of sites favouring an electronic investigator site file (ISF), information technology requirements and clinical trial unit (CTU) operating procedures mandated the ongoing use of paper ISFs; site start-up delays resulted from restricted access to the CTU. Site initiation visits (SIVs) were conducted remotely; 50% of sites preferred remote SIVs and 44% felt that it was trial-dependent, while few preferred SIVs in-person as standard procedure. The Central team felt remote SIVs provided scheduling and attendance flexibility (for sites and trial staff), the option of recording discussions for missing or future staff, improved efficiency by having multiple sites attend, and time and cost savings; the negative impact on rapport-building and interaction was partially mitigated over time with more familiarity with technology and new ways-of-working. Two methods of remote consent were developed and used by 30/37 sites and for 54/156 recruits. Most (86%) sites using remote consenting felt it improved recruitment. For remote data monitoring (5 sites), advantages were primarily for the monitor (e.g. flexibility, no time constraints, reduced cost), and disadvantages primarily for the sites (e.g. document and access preparation, attendance at a follow-up meeting), but 81% of sites desired having the option of remote monitoring post-pandemic.

conclusionsCOVID adaptations to WILL trial processes improved the flexibility of trial delivery, for Central and site staff, and participants. Flexibility to use these strategies should be retained post-pandemic.

trial registrationISRCTN77258279. Registered on 05 December 2018.

Indexed as

COVID-19HypertensionLabor, ObstetricFemaleHumansMulticenter Studies as TopicPandemicsPragmatic Clinical Trials as TopicPregnancyRandomized Controlled Trials as TopicSARS-CoV-2COVIDPregnancyRemote consentTiming of birthTrial management

Identifiers

PMID36271441
PMCPMC9585855

What OpenQuestion holds

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LicenceCC BY
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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.