Cited by 307Ethics in Clinical ResearchStatistical Methods in Clinical TrialsMeta-analysis and systematic reviews

Strategies for Increasing Recruitment to Randomised Controlled Trials: Systematic Review

Open access
Caldwell, Patrina H. Y., Hamilton, Sana, Tan, Alvin, Craig, Jonathan C.·2010·PLoS Medicine

Abstract

BACKGROUND: Recruitment of participants into randomised controlled trials (RCTs) is critical for successful trial conduct. Although there have been two previous systematic reviews on related topics, the results (which identified specific interventions) were inconclusive and not generalizable. The aim of our study was to evaluate the relative effectiveness of recruitment strategies for participation in RCTs. METHODS AND FINDINGS: A systematic review, using the PRISMA guideline for reporting of systematic reviews, that compared methods of recruiting individual study participants into an actual or mock RCT were included. We searched MEDLINE, Embase, The Cochrane Library, and reference lists of relevant studies. From over 16,000 titles or abstracts reviewed, 396 papers were retrieved and 37 studies were included, in which 18,812 of at least 59,354 people approached agreed to participate in a clinical RCT. Recruitment strategies were broadly divided into four groups: novel trial designs (eight studies), recruiter differences (eight studies), incentives (two studies), and provision of trial information (19 studies). Strategies that increased people's awareness of the health problem being studied (e.g., an interactive computer program [relative risk (RR) 1.48, 95% confidence interval (CI) 1.00-2.18], attendance at an education session [RR 1.14, 95% CI 1.01-1.28], addition of a health questionnaire [RR 1.37, 95% CI 1.14-1.66]), or a video about the health condition (RR 1.75, 95% CI 1.11-2.74), and also monetary incentives (RR1.39, 95% CI 1.13-1.64 to RR 1.53, 95% CI 1.28-1.84) improved recruitment. Increasing patients' understanding of the trial process, recruiter differences, and various methods of randomisation and consent design did not show a difference in recruitment. Consent rates were also higher for nonblinded trial design, but differential loss to follow up between groups may jeopardise the study findings. The study's main limitation was the necessity of modifying the search strategy with subsequent search updates because of changes in MEDLINE definitions. The abstracts of previous versions of this systematic review were published in 2002 and 2007. CONCLUSION: Recruitment strategies that focus on increasing potential participants' awareness of the health problem being studied, its potential impact on their health, and their engagement in the learning process appeared to increase recruitment to clinical studies. Further trials of recruitment strategies that target engaging participants to increase their awareness of the health problems being studied and the potential impact on their health may confirm this hypothesis. Please see later in the article for the Editors' Summary.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pmed.1000368

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 55 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. [8]Zifferblatt SM 1975 Recruitment in large-scale clinical trials. Weiss SM Proceedings of the National Heart and Lung Institute Working Conference on health behavior Bethesda NIH 187 195
  2. [11]Caldwell P Craig J Hamilton S Butow PN 2002 Strategies for recruitment to RCTs: a systematic review of controlled trials and observational studies. 2002 Oct 21; Sydney, Australia; International Clinical Trials Symposium: improving health care in the new millennium. http://www.ctc.usyd.edu.au/education/4news/Symposium2002_report/caldwell.htm
  3. [12]Caldwell P Craig J Hamilton S Butow PN 2007 Systematic review of strategies for enhancing recruitment of participants for randomised controlled trials. 2007 Sep 24; Sydney, Australia; International Clinical Trials Symposium
  4. [13]Higgins J Green S Cochrane C 2008 Cochrane handbook for systematic reviews of interventions Chichester, England Wiley-Blackwell
  5. [23]Quinaux E Lienard JL Slimani Z Jouhard A Piedbois P Buyse M 2003 Impact of monitoring visits on patient recruitment and data quality: case study of a phase IV trial in oncology. Control Clin Trials 24 99S [conference abstract] 17060222

Cited by

Sorted by citations

Authors
Caldwell, P. H. Y., Hamilton, S., Tan, A., & Craig, J. C.
Affiliations
  • The University of Sydney (AU)
  • Children's Hospital at Westmead (AU)
Corresponding author
Caldwell, Patrina H. Y.
Venue
PLoS Medicine
Published
2010-11-09
Volume
7
Issue
11
Pages
e1000368
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
OpenAlex
W2121847763
Cited by
307
References
55
Citations by year
2026: 6 · 2025: 19 · 2024: 19 · 2023: 28 · 2022: 24 · 2021: 23 · 2020: 19 · 2019: 18 · 2018: 27 · 2017: 21 · 2016: 18 · 2015: 22 · 2014: 13 · 2013: 22 · 2012: 18
FWCI
2.31
Type
journal article
Language
en
Open access
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of Sydney
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Keywords
randomized controlled trials, clinical trial participation, participant awareness, financial incentives, trial design, informed consent, loss to follow-up, mock trial, health education
MeSH terms
Humans, Patient Education as Topic, Randomized Controlled Trials as Topic, Sample Size

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review