S J Rolnick1, S K Flores, S E Fowler, R Derman, B Davidson. 1. HealthPartners Research Foundation, 8100 34th Avenue South, P.O. Box 1524, Minneapolis, MN 55440-1524, USA. cheri.j.rolnick@healthpartners.com
Abstract
OBJECTIVE: To conduct a randomized, controlled trial (RCT) to examine issues associated with therapeutic alternatives to standard hysterectomy for women with dysfunctional uterine bleeding. STUDY DESIGN: Participants were to be randomly assigned to one of three treatment groups: hysterectomy, endometrial ablation and medical management. Recruitment was targeted at 375 women. RESULTS: Despite multiple recruitment strategies, recruitment was weak, with only five women enrolled after six months. Providers and women screened for eligibility often expressed discomfort with randomization. The protocol was amended to an elective treatment cohort design with a randomization component. Recruitment improved, with 37 women enrolled after four months. CONCLUSION: The success of RCTs may be affected by multiple factors. Acceptance of the protocol by patients and providers is essential. The RCT may present providers with a conflict between the goals of research and of providing optimal individualized care. Thus, RCTs may not always be appropriate for studies designed to examine best treatments in clinical practice, and nonrandomized designs may provide appropriate alternatives in some cases.
RCT Entities:
OBJECTIVE: To conduct a randomized, controlled trial (RCT) to examine issues associated with therapeutic alternatives to standard hysterectomy for women with dysfunctional uterine bleeding. STUDY DESIGN:Participants were to be randomly assigned to one of three treatment groups: hysterectomy, endometrial ablation and medical management. Recruitment was targeted at 375 women. RESULTS: Despite multiple recruitment strategies, recruitment was weak, with only five women enrolled after six months. Providers and women screened for eligibility often expressed discomfort with randomization. The protocol was amended to an elective treatment cohort design with a randomization component. Recruitment improved, with 37 women enrolled after four months. CONCLUSION: The success of RCTs may be affected by multiple factors. Acceptance of the protocol by patients and providers is essential. The RCT may present providers with a conflict between the goals of research and of providing optimal individualized care. Thus, RCTs may not always be appropriate for studies designed to examine best treatments in clinical practice, and nonrandomized designs may provide appropriate alternatives in some cases.
Authors: Linda Brubaker; Pamela Moalli; Holly E Richter; Michael Albo; Larry Sirls; Toby Chai; Stephen R Kraus; Peggy Norton; Debuene Chang; Sharon L Tennstedt Journal: Clin Trials Date: 2009-07-22 Impact factor: 2.486
Authors: Elizabeth A Stewart; Barbara L Lytle; Laine Thomas; Ganesa R Wegienka; Vanessa Jacoby; Michael P Diamond; Wanda K Nicholson; Raymond M Anchan; Sateria Venable; Kedra Wallace; Erica E Marsh; George L Maxwell; Bijan J Borah; William H Catherino; Evan R Myers Journal: Am J Obstet Gynecol Date: 2018-05-08 Impact factor: 8.661