An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.

<h4>Objectives</h4>To determine the association between intensive care unit (ICU) characteristics and clinicians' decision to decline eligible patients for randomization into a multicentered pragmatic comparative-effectiveness controlled trial.<h4>Methods</h4>Screening l...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mahesh Ramanan, Laurent Billot, Dorrilyn Rajbhandari, John Myburgh, Balasubramanian Venkatesh
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4458010f4fb04b769c2713dded1ecc1c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4458010f4fb04b769c2713dded1ecc1c
record_format	dspace
spelling	oai:doaj.org-article:4458010f4fb04b769c2713dded1ecc1c2021-12-02T20:06:24ZAn evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.1932-620310.1371/journal.pone.0255361https://doaj.org/article/4458010f4fb04b769c2713dded1ecc1c2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255361https://doaj.org/toc/1932-6203<h4>Objectives</h4>To determine the association between intensive care unit (ICU) characteristics and clinicians' decision to decline eligible patients for randomization into a multicentered pragmatic comparative-effectiveness controlled trial.<h4>Methods</h4>Screening logs from the Adjunctive Glucocorticoid Therapy in Septic Shock Trial (ADRENAL) and site-level data from the College of Intensive Care Medicine and Australia New Zealand Intensive Care Society were examined. The effects of ICU characteristics such as tertiary academic status, research coordinator availability, number of admissions, and ICU affiliations on clinicians declining to randomize eligible patients were calculated using mixed effects logistic regression modelling.<h4>Results</h4>There were 21,818 patients screened for inclusion in the ADRENAL trial at 69 sites across five countries, out of which 5,501 were eligible, 3,800 were randomized and 659 eligible patients were declined for randomization by the treating clinician. The proportion of eligible patients declined by clinicians at individual ICUs ranged from 0 to41%. In the multivariable model, none of the ICU characteristics were significantly associated with higher clinician decline rate.<h4>Conclusions</h4>Neither tertiary academic status, nor other site-level variables were significantly associated with increased rate of clinicians declining eligible patients.Mahesh RamananLaurent BillotDorrilyn RajbhandariJohn MyburghBalasubramanian VenkateshPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255361 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mahesh Ramanan Laurent Billot Dorrilyn Rajbhandari John Myburgh Balasubramanian Venkatesh An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
description	<h4>Objectives</h4>To determine the association between intensive care unit (ICU) characteristics and clinicians' decision to decline eligible patients for randomization into a multicentered pragmatic comparative-effectiveness controlled trial.<h4>Methods</h4>Screening logs from the Adjunctive Glucocorticoid Therapy in Septic Shock Trial (ADRENAL) and site-level data from the College of Intensive Care Medicine and Australia New Zealand Intensive Care Society were examined. The effects of ICU characteristics such as tertiary academic status, research coordinator availability, number of admissions, and ICU affiliations on clinicians declining to randomize eligible patients were calculated using mixed effects logistic regression modelling.<h4>Results</h4>There were 21,818 patients screened for inclusion in the ADRENAL trial at 69 sites across five countries, out of which 5,501 were eligible, 3,800 were randomized and 659 eligible patients were declined for randomization by the treating clinician. The proportion of eligible patients declined by clinicians at individual ICUs ranged from 0 to41%. In the multivariable model, none of the ICU characteristics were significantly associated with higher clinician decline rate.<h4>Conclusions</h4>Neither tertiary academic status, nor other site-level variables were significantly associated with increased rate of clinicians declining eligible patients.
format	article
author	Mahesh Ramanan Laurent Billot Dorrilyn Rajbhandari John Myburgh Balasubramanian Venkatesh
author_facet	Mahesh Ramanan Laurent Billot Dorrilyn Rajbhandari John Myburgh Balasubramanian Venkatesh
author_sort	Mahesh Ramanan
title	An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
title_short	An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
title_full	An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
title_fullStr	An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
title_full_unstemmed	An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
title_sort	evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4458010f4fb04b769c2713dded1ecc1c
work_keys_str_mv	AT maheshramanan anevaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT laurentbillot anevaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT dorrilynrajbhandari anevaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT johnmyburgh anevaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT balasubramanianvenkatesh anevaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT maheshramanan evaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT laurentbillot evaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT dorrilynrajbhandari evaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT johnmyburgh evaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare AT balasubramanianvenkatesh evaluationoffactorsthatmayinfluencecliniciansdecisionsnottoenrolleligiblepatientsintorandomizedtrialsincriticalcare
_version_	1718375356270903296

An evaluation of factors that may influence clinicians' decisions not to enroll eligible patients into randomized trials in critical care.

Ejemplares similares