The PROMoting the USE of SWATs (PROMETHEUS) programme: Lessons learnt and future developments for SWATs

Area of Science:

• Clinical Trials Methodology
• Health Services Research

Background:

• The PROMETHEUS programme aimed to enhance the evidence base for strategies improving participant recruitment and retention in clinical trials.
• Funded by the UK Medical Research Council (MRC) and National Institute for Health Research (NIHR), it focused on developing and implementing Studies within a Trial (SWATs).

Purpose of the Study:

• To present observations and outcomes from the PROMETHEUS programme regarding the coordination and execution of SWATs.
• To identify needs and propose future directions for advancing SWAT research and its integration into host trials.

Main Methods:

• The PROMETHEUS programme funded 42 SWATs with an average cost of £4007 per study.
• A central coordination point facilitated concentrated research activity, establishing the methodological feasibility of coordinated SWAT design.
• The international Trial Forge SWAT Network was established to connect research groups involved in methodological research.

Main Results:

• A rapid increase in the SWAT evidence base was achieved through coordinated efforts.
• The methodological feasibility of undertaking coordinated SWAT designs was successfully established.
• The development of a SWAT reporting template and a peer-review database were identified as needs for improving SWAT reporting.

Conclusions:

• The coordination provided by PROMETHEUS was crucial for expanding the recruitment and retention evidence base.
• The Trial Forge Network is essential for continued networking and dissemination of SWAT research findings.
• Future work should focus on developing strategies for SWAT identification, communication of research priorities, and refining the SWAT approvals process.