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Study Design Features Associated with Patient Attrition in Studies of Traumatic Brain Injury: A Systematic Review
Sophie Richter1, Susan Stevenson1, Tom Newman1
1University Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
Journal of Neurotrauma
|April 30, 2020
Summary
Patient attrition in traumatic brain injury (TBI) studies is influenced by study design. Higher follow-up frequency and mild TBI enrollment increase attrition, while acute care recruitment and longer follow-up durations decrease it.
Area of Science:
- Neuroscience
- Clinical Research Methodology
- Public Health
Background:
- Patient attrition, or loss to follow-up, is a significant challenge in longitudinal studies, particularly those investigating traumatic brain injury (TBI).
- Understanding the relationship between study design elements and patient attrition is crucial for improving data integrity and research outcomes in TBI research.
Purpose of the Study:
- To systematically review and identify specific features of study design that are associated with patient attrition in traumatic brain injury (TBI) research.
- To extend a previous systematic review on missing data in TBI studies, focusing on the Glasgow Outcome Scale Extended (GOSE) as a key outcome measure.
Main Methods:
- Analysis extended from a prior systematic review, examining 148 TBI studies that reported attrition and used the GOSE.
- Logistic regression was employed to assess the association between 14 distinct study design features and patient attrition.
Main Results:
- Seven study design features were significantly associated with patient attrition.
- Increased attrition was linked to higher follow-up frequency, single-center designs, exclusive enrollment of mild TBI patients, and non-face-to-face data collection (e.g., mail, phone).
- Reduced attrition was associated with recruitment in acute care settings (ward/ICU) and longer time intervals between injury and follow-up.
Conclusions:
- Specific study design choices can significantly impact patient retention in TBI research.
- Consideration of factors like recruitment setting, follow-up frequency, and data collection methods is vital for minimizing attrition and enhancing the reliability of longitudinal TBI studies.
