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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Recruitment and adherence of randomized controlled trials for mild cognitive impairment: A systematic review and
Zijun Xu1, Wen Sun1, Dexing Zhang1
1Division of Family Medicine and Primary Health Care, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Objectives:
The recruitment and adherence status of randomized controlled trials (RCTs) for population with mild cognitive impairment (MCI) are little known. We aimed to explore the RCT recruitment and adherence status and factors associated with these among MCI patients.
Methods:
We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, and PsycARTICLES from inception to 8th July 2019. Included studies were RCTs conducted among MCI patients with available data of invitation rate, eligibility rate, randomization rate, recruitment rate, adherence rate, satisfaction rate, or potential barrier for recruitment and compliance. Two authors screened the studies and extracted the data independently. We calculated pooled proportions of each rate and their 95% confidence intervals (CIs) using random-effects meta-analysis. Meta-regression and subgroup analysis was conducted.
Results:
Hundred and ten articles were judged to meet the study inclusion criteria from 10 387 articles. The invitation rates ranged from 9% to96% but were not pooled together due to high heterogeneity. The pooled overall eligibility, randomization, recruitment, intervention adherence, and follow-up adherence rates were 55% (95% CI: 48%-62%), 86% (95% CI: 81%-91%), 44% (95% CI: 37%-50%), 88% (95% CI: 86%-90%), and 85% (95% CI: 83%-87%), respectively. Non-MCI (47.5%), disease or medical problems (13.8%), and loss of interest (8.5%) were the most frequent reasons for screen failure. Refusal without reason (36.6%), adverse events (30.9%), and health issues (7.7%) were the most frequent reasons for drop-out.
Conclusions:
This study provided important information for future RCTs targeting at MCI patients. Strategies designed to improve participant recruitment and RCT adherence should be developed among this population.
Insights
Recruitment and adherence in randomized controlled trials (RCTs) for mild cognitive impairment (MCI) patients are critical. This meta-analysis reveals pooled recruitment and adherence rates, offering insights for future trial strategies.
Area of Science:
- Clinical Trials
- Neuroscience
- Gerontology
Background:
- Recruitment and adherence are crucial for the validity of randomized controlled trials (RCTs) in populations with mild cognitive impairment (MCI).
- Limited data exists on the status of recruitment and adherence in MCI-focused RCTs.
- Understanding these factors is essential for designing effective future trials.
Purpose of the Study:
- To explore the recruitment and adherence status of RCTs involving patients with MCI.
- To identify factors associated with recruitment and adherence challenges in MCI RCTs.
Main Methods:
- A systematic literature search was conducted across multiple databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, PsycARTICLES) up to July 2019.
- Included studies were RCTs with available data on invitation, eligibility, randomization, recruitment, adherence, and barriers.
- Pooled proportions and confidence intervals were calculated using random-effects meta-analysis, with meta-regression and subgroup analyses performed.
Main Results:
- 110 articles met inclusion criteria from over 10,000 initial records.
- Pooled rates included: eligibility 55%, randomization 86%, recruitment 44%, intervention adherence 88%, and follow-up adherence 85%.
- Common reasons for screen failure included non-MCI status (47.5%) and medical problems (13.8%). Frequent reasons for drop-out were refusal without reason (36.6%) and adverse events (30.9%).
Conclusions:
- This meta-analysis provides essential data on recruitment and adherence rates in MCI RCTs.
- Findings highlight the need for targeted strategies to enhance participant recruitment and adherence in this population.
- Future research should focus on developing and testing interventions to improve trial participation and completion among individuals with MCI.
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