Related Experiment Videos

Attrition in randomized controlled trials for pediatric chronic conditions

Cynthia W Karlson1, Michael A Rapoff

  • 1Department of Psychology, University of Kansas, Lawrence, Kansas 66045, USA. ckarlson@ku.edu

Journal of Pediatric Psychology
|December 10, 2008
PubMed

Insights

High attrition rates were found in randomized controlled trials for pediatric chronic illness cognitive behavioral interventions. Strategies like tailored recruitment and incentives can reduce participant dropout, improving trial validity.

Area of Science:

  • Pediatric Psychology
  • Clinical Trials Methodology
  • Behavioral Medicine

Background:

  • Cognitive behavioral interventions (CBIs) are used for children with chronic illnesses.
  • Attrition in randomized controlled trials (RCTs) can impact study validity.
  • Understanding attrition in pediatric CBI RCTs is crucial for effective research.

Purpose of the Study:

  • To examine attrition variables in RCTs of CBIs for children with chronic illnesses.
  • To identify factors contributing to participant dropout in pediatric CBI research.

Main Methods:

  • Reviewed 40 RCTs of CBIs for children with chronic medical conditions (e.g., asthma, diabetes, cancer).
  • Studies were published between 2002-2007 in six pediatric research journals.
  • Analyzed reported attrition rates for initial and extended follow-up.

Main Results:

  • Mean enrollment refusal rate was 37% (range 0-75%).
  • Mean attrition rates were 20% for initial follow-up and 32% for extended follow-up.
  • Only 40% of reviewed articles included a CONSORT diagram.

Conclusions:

  • Tailored recruitment, personalized feedback, consistent procedures, incentives, and intensive tracking can reduce attrition.
  • Standardized definitions and reporting of attrition are needed in pediatric CBI RCTs.
  • Addressing attrition is essential for robust evidence in pediatric behavioral health research.
Abstract

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Longitudinal Research02:20

Longitudinal Research

Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Randomized Experiments01:13

Randomized Experiments

The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...