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Do health care institutions value research? A mixed methods study of barriers and facilitators to methodological
Michele P Hamm1, Shannon D Scott, Terry P Klassen
1Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. michele.hamm@ualberta.ca
Insights
Pediatric trialists face barriers to unbiased research due to inconsistent awareness of bias and negative research attitudes. Improving knowledge translation is crucial for rigorous pediatric randomized controlled trials (RCTs).
Area of Science:
- Clinical Trials
- Pediatric Research
- Bias in Research
Background:
- Pediatric randomized controlled trials (RCTs) often have a high risk of bias.
- Understanding barriers and facilitators for unbiased pediatric trials is essential.
Purpose of the Study:
- To examine barriers and facilitators pediatric trialists encounter in designing and conducting unbiased trials.
- To assess trialists' knowledge and awareness of bias in pediatric research.
Main Methods:
- Mixed methods design combining quantitative surveys with semi-structured interviews.
- Surveyed 253 Canadian and 600 international pediatric trialists on bias awareness and perceived barriers/facilitators.
- Interviewed 13 participants to explore interactions between research experiences, attitudes, and trial conduct.
Main Results:
- Survey response rate was 23.0% (186/807).
- 68.1% recognized bias as a problem in pediatric RCTs; 72.0% supported changes in trial conduct.
- Inconsistent awareness of bias-inducing study design features noted; lack of formal training and negative research culture identified as barriers.
- Supportive colleagues and research infrastructure emerged as facilitators.
Conclusions:
- Lack of bias awareness and negative research attitudes significantly hinder methodologically rigorous pediatric RCTs.
- Knowledge translation initiatives must address these issues to ensure the relevance and validity of trial findings.
Background:
Pediatric randomized controlled trials (RCTs) are susceptible to a high risk of bias. We examined the barriers and facilitators that pediatric trialists face in the design and conduct of unbiased trials.
Methods:
We used a mixed methods design, with semi-structured interviews building upon the results of a quantitative survey. We surveyed Canadian (n=253) and international (n=600) pediatric trialists regarding their knowledge and awareness of bias and their perceived barriers and facilitators in conducting clinical trials. We then interviewed 13 participants from different subspecialties and geographic locations to gain a more detailed description of how their experiences and attitudes towards research interacted with trial design and conduct.
Results:
The survey response rate was 23.0% (186/807). 68.1% of respondents agreed that bias is a problem in pediatric RCTs and 72.0% felt that there is sufficient evidence to support changing some aspects of how trials are conducted. Knowledge related to bias was variable, with inconsistent awareness of study design features that may introduce bias into a study. Interview participants highlighted a lack of formal training in research methods, a negative research culture, and the pragmatics of trial conduct as barriers. Facilitators included contact with knowledgeable and supportive colleagues and infrastructure for research.
Conclusions:
A lack of awareness of bias and negative attitudes towards research present significant barriers in terms of conducting methodologically rigorous pediatric RCTs. Knowledge translation efforts must focus on these issues to ensure the relevance and validity of trial results.
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