Optimising recruitment to the HAND-1 RCT feasibility study:integration 1 of the QuinteT Recruitment Intervention (QRI)

© 2020, The Author(s). Background: Recruitment to randomised controlled trials (RCTs) can be challenging, with most trials not reaching recruitment targets. Randomised feasibility studies can be set up prior to a main trial to identify and overcome recruitment obstacles. This paper reports on an intervention—the QuinteT Recruitment Intervention (QRI)—to optimise recruitment within a randomised feasibility study of surgical treatments for patients with Dupuytren’s contracture (the HAND-1 study). Methods: The QRI was introduced in 2-phases: phase 1 sought to understand the recruitment challenges by interviewing trial staff, scrutinising screening logs and analysing audio-recorded patient consultations; in phase 2 a tailored plan of action consisting of recruiter feedback and training was delivered to address the identified challenges. Results: Two key recruitment obstacles emerged: (1) issues with the recruitment pathway, in particular methods to identify potentially eligible patients and (2) equipoise of recruiters and patients. These were addressed by liaising with centres to share good practice and refine their pathway and by providing bespoke feedback and training on consent discussions to individual recruiters and centres whilst recruitment was ongoing. The HAND-1 study subsequently achieved its recruitment target. Conclusions: Transferable lessons learnt from the QRI in the feasibility study will be implemented in the definitive RCT, enabling a “head start” in the tackling of wider issues around screening methods and consent discussions in the set up/early recruitment study phases, with ongoing QRI addressing specific issues with new centres and recruiters. Findings from this study are likely to be relevant to other surgical and similar trials that are anticipated to encounter issues around patient and recruiter equipoise of treatments and variation in recruitment pathways across centres. The study also highlights the value of feasibility studies in fine-tuning design and conduct issues for definitive RCTs. Embedding a QRI in an RCT, at feasibility or main stage, offers an opportunity for a detailed and nuanced understanding of key recruitment challenges and the chance to address them in “real-time” as recruitment proceeds

Overview of Australian Indigenous health status, 2014

The main purpose of the Overview is to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islander peoples. It has been prepared by the Australian Indigenous HealthInfoNet as a part of our contribution to ‘closing the gap’ in health between Aboriginal and Torres Strait Islander people and other Australians by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, other health professionals including Health workers, program managers, clinicians, researchers, students and the general community. The initial sections of this Overview provide information about the context of Aboriginal and Torres Strait Islander health, Aboriginal and Torres Strait Islander population, and various measures of population health status. Most of the subsequent sections about specific health conditions comprise an introduction about the condition and evidence of the current burden of the condition among Aboriginal and Torres Strait Islander people. Information is provided for state and territories and for demographics such as gender and age when it is available and appropriate. While the Overview provides a comprehensive review of key indicators across a range of health topics, it is beyond the scope to provide detailed information on other aspects, such as the availability and use of services (including barriers to their use) and strategies and policies related to specific health topics. Interested readers should refer to the topic-specific reviews that are available on the HealthInfoNet’s website. Additional, more in depth, information about the topics summarised in this Overview is included in the corresponding sections of the HealthInfoNet’s website (www.healthinfonet.ecu.edu.au). There are a number of additions to this Overview. We have included a recognition statement, a note on the use of appropriate terminology that introduces our guidelines on the matter, and a statement of commitment to enhancing our strengths based approach to reporting

Overview of Aboriginal and Torres Strait Islander health status, 2017

The Overview of Aboriginal and Torres Strait Islander health status (Overview) aims to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islander people. The initial sections of the Overview provide information about the context of Aboriginal and Torres Strait Islander health, population, and various measures of population health status. The remaining sections are about selected health conditions and risk and protective factors that contribute to the overall health of Aboriginal and Torres Strait Islander people. These sections comprise an introduction and evidence of the extent of the condition or risk/protective factor. The annual Overview is a resource relevant for workers, students and others who need to access up-to-date information about Aboriginal and Torres Strait Islander health

Overview of Aboriginal and Torres Strait Islander health status, 2015

The main purpose of the Overview is to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islanders people. It has been prepared by Australian Indigenous HealthInfoNet staff as part of our contribution to supporting those who work in the Aboriginal and Torres Strait Islander health sector. The Overview is a key element of the HealthInfoNet commitment to authentic and engaged knowledge development and exchange. The initial sections of this Overview provide information about the context of Aboriginal and Torres Strait Islander health, population, and various measures of population health status. Most of the subsequent sections about specific health conditions comprise an introduction about the condition and evidence of the current burden of the condition among Aboriginal and Torres Strait Islander people. Information is provided for state and territories and for demographics such as sex and age when it is available and appropriate

Overview of Australian Aboriginal and Torres Strait Islander health status 2016

This report provides a comprehensive overview of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people. Information focuses on: Aboriginal and Torres Strait Islander populations the context of Aboriginal and Torres Strait Islander health various measures of population health status selected health conditions health risk and protective factors. The Overview shows that the health of Aboriginal and Torres Strait Islander people continues to improve slowly and there has been a decline in the death rates for Aboriginal and Torres Strait Islander people and also a significant closing of the gap in death rates between Aboriginal and Torres Strait Islander and non-Indigenous people. The infant mortality rate has declined significantly. There have also been improvements in a number of areas contributing to health status such as the proportion of Aboriginal and Torres Strait Islander mothers who smoked during pregnancy has decreased. There has been a slight decrease in the proportion of low birth weight babies born to Aboriginal and Torres Strait Islander mothers between 2004 and 2014. Age-standardised death rates for respiratory disease in NSW, Qld, WA, SA and NT declined by 26% over the period 1998-2012 for Aboriginal and Torres Strait Islander people. Two new sections are featured in this edition of the Overview. With the 20th anniversary of the Bringing them home report, a section has been dedicated to Healing which highlights the contribution of healing workers and organisations to supporting people, families and communities impacted by the Stolen Generations. Environmental health with its important link to the social determinants of health is also included for the first time in the Overview 2016

Utilization of volumetric magnetic resonance imaging for baseline and surveillance imaging in Neuro-oncology.

The acquisition of volumetric post-contrast MRI has clear advantages in the interpretation of neuro-oncology studies but has yet to find its way into routine clinical practice beyond planning scans for surgery and radiotherapy. This commentary briefly highlights the benefits of these techniques whilst dispelling some of the perceived disadvantages

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist