Evidence map›Paper›PMID 39894513›Full record

ArticleBMJ open2025

Protocol for an adaptive platform trial of intended service user-derived interventions to equitably reduce non-attendance in eye screening programmes in Botswana, India, Kenya and Nepal.

Luke Allen, Min Kim, Malebogo Tlhajoane, David Macleod, Oathokwa Nkomazana, Michael Gichangi, Sailesh Mishra, Shalinder Sabherwal, James R Carpenter, Sarah Karanja and 6 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Clinical trial methods for family medicine and primary care.African journal of primary health care & family medicine · 2025
    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

16 authors.

Luke AllenLondon School of Hygiene & Tropical Medicine, London, UK Luke.Allen@lshtm.ac.uk.
Min KimLondon School of Hygiene & Tropical Medicine, London, UK.
Malebogo TlhajoaneLondon School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-0601-5516
David MacleodLondon School of Hygiene & Tropical Medicine, London, UK.
Oathokwa NkomazanaDepartment of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Michael GichangiMinistry of Public Health and Sanitation, Division of Preventive Ophthalmic Services, Nairobi, Kenya.
Sailesh MishraNepal Netra Jyoti Sangh, Kathmandu, Nepal.
Shalinder SabherwalDr Shroff's Charity Eye Hospital Delhi, Delhi, New Delhi, India.ORCID http://orcid.org/0000-0001-7687-0748
James R CarpenterLondon School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0003-3890-6206
Sarah KaranjaPopulation Health and Primary Care, Kenya Medical Research Institute, Nairobi, Kenya.
Ari Ho-FosterDepartment of Health Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Bakgaki RatshaaDepartment of Health Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Nigel BolsterLondon School of Hygiene & Tropical Medicine, London, UK.
Jacqueline RamkeLondon School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-5764-1306
Matthew J BurtonLondon School of Hygiene & Tropical Medicine, London, UK.
Andrew BastawrousLondon School of Hygiene & Tropical Medicine, London, UK.

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionOnly 30%-50% of people referred to clinics during community-based eye screening are able to access care in Botswana, India, Kenya and Nepal. The access rate is even lower for certain population groups. This platform trial aims to test multiple, iterative, low-risk public health interventions and simple service modifications with a series of individual randomised controlled trials (RCT) conducted in each country, with the aim of increasing the proportion of people attending. METHODS AND ANALYSIS: We will set up a platform trial in each country to govern the running of a series of pragmatic, adaptive, embedded, parallel, multiarm, superiority RCTs to test a series of service modifications suggested by intended service users. The aim is to identify serial marginal gains that cumulatively result in large improvements to equity and access. The primary outcome will be the probability of accessing treatment among the population group with the worst access at baseline. We will calculate Bayesian posterior probabilities of clinic attendance in each arm every 72 hours. Each RCT will continually recruit participants until the following default stopping rules have been met: >95% probability that one arm is best; >95% probability that the difference between the best arm and the arms remaining in the trial is <1%; or 10 000 people have been recruited. Lower thresholds may be used for RCTs testing interventions with very low risks and costs. The specific design of cluster RCTs will be determined by our research team once the intervention is known, but the population and outcome will be the same across all trials.This adaptive platform trial will be used to identify effective service modifications, driving continuous improvements in access. ETHICS AND DISSEMINATION: This trial has been approved by the research ethics committee at the London School of Hygiene & Tropical Medicine (ref: 29549). Approvals for individual interventions will be sought from UK and local ethics committees. Results will be shared via local workshops, social media and peer-reviewed publications. TRIAL REGISTRATION NUMBER: ISRCTN53970958.

Indexed as

Health Services AccessibilityVision ScreeningBayes TheoremBotswanaEquivalence Trials as TopicHumansIndiaKenyaNepalPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopiceHealthHealth EquityHealth ServicesPublic Health

Identifiers

PMID39894513
PMCPMC11792273

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.