Skip to main content

Research Repository

Advanced Search

Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies

Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies Thumbnail


Abstract

Objectives
Designing studies with an internal pilot phase may optimise the use of pilot work to inform more efficient randomised controlled trials (RCTs). Careful selection of preagreed decision or ‘progression’ criteria at the juncture between the internal pilot and main trial phases provides a valuable opportunity to evaluate the likely success of the main trial and optimise its design or, if necessary, to make the decision not to proceed with the main trial. Guidance on the appropriate selection and application of progression criteria is, however, lacking. This paper outlines the key issues to consider in the optimal development and review of operational progression criteria for RCTs with an internal pilot phase.

Design
A structured literature review and exploration of stakeholders’ opinions at a Medical Research Council (MRC) Hubs for Trials Methodology Research workshop. Key stakeholders included triallists, methodologists, statisticians and funders.

Results
There is considerable variation in the use of progression criteria for RCTs with an internal pilot phase, although 3 common issues predominate: trial recruitment, protocol adherence and outcome data. Detailed and systematic reporting around the decisionmaking process for stopping, amending or proceeding to a main trial is uncommon, which may hamper understanding in the research community about the appropriate and optimal use of RCTs with an internal pilot phase. 10 top tips for the development, use and reporting of progression criteria for internal pilot studies are presented.

Conclusions
Systematic and transparent reporting of the design, results and evaluation of internal pilot trials in the literature should be encouraged in order to facilitate understanding in the research community and to inform future trials.

Acceptance Date Jan 19, 2017
Publication Date Feb 17, 2017
Publicly Available Date Mar 28, 2024
Journal BMJ Open
Publisher BMJ Publishing Group
Pages e013537 - e013537
DOI https://doi.org/10.1136/bmjopen-2016-013537
Keywords randomised controlled trials; pilot studies
Publisher URL https://bmjopen.bmj.com/content/7/2/e013537

Files




Downloadable Citations