Providing multimedia information to children and young people increases recruitment to trials: pre-planned meta-analysis of SWATs.

BACKGROUND: Randomised controlled trials are often beset by problems with poor recruitment and retention. Information to support decisions on trial participation is usually provided as printed participant information sheets (PIS), which are often long, technical, and unappealing. Multimedia information (MMI), including animations and videos, may be a valuable alternative or complement to a PIS. The Trials Engagement in Children and Adolescents (TRECA) study compared MMI to PIS to investigate the effects on participant recruitment, retention, and quality of decision-making. METHODS: We undertook six SWATs (Study Within A Trial) within a series of host trials recruiting children and young people. Potential participants in the host trials were randomly allocated to receive MMI-only, PIS-only, or combined MMI + PIS. We recorded the rates of recruitment and retention (varying between 6 and 26 weeks post-randomisation) in each host trial. Potential participants approached about each host trial were asked to complete a nine-item Decision-Making Questionnaire (DMQ) to indicate their evaluation of the information and their reasons for participation/non-participation. Odds ratios were calculated and combined in a meta-analysis. RESULTS: Data from 3/6 SWATs for which it was possible were combined in a meta-analysis (n = 1758). Potential participants allocated to MMI-only were more likely to be recruited to the host trial than those allocated to PIS-only (OR 1.54; 95% CI 1.05, 2.28; p = 0.03). Those allocated to combined MMI + PIS compared to PIS-only were no more likely to be recruited to the host trial (OR = 0.89; 95% CI 0.53, 1.50; p = 0.67). Providing MMI rather than PIS did not impact on DMQ scores. Once children and young people had been recruited to host trials, their trial retention rates did not differ according to intervention allocation. CONCLUSIONS: Providing MMI-only increased the trial recruitment rate compared to PIS-only but did not affect DMQ scores. Combined MMI + PIS instead of PIS had no effect on recruitment or retention. MMIs are a useful tool for trial recruitment in children and young people, and they could reduce trial recruitment periods.

Developmental stages of the Japanese quail.

Developmental biology research has used various avian species as model organisms for studying morphogenesis, with the chick embryo being used by the majority of groups. The focus on the chick embryo led Hamburger and Hamilton to develop their definitive staging series nearly 60 years ago and this series is still the mainstay of all laboratories working with avian embryos. The focus on the chick embryo has somewhat overshadowed the importance of another avian embryo that has proved to be equally powerful, the Japanese quail. Since the late 1960s, chimeras have been produced using chick and quail embryos and this technique has revolutionized the approach taken to the investigation of the cellular and molecular interactions that occur during development. Reviews of the literature demonstrate that many research groups are using the quail embryo in a number of established and new ways, and this species has become a primary animal model in developmental biology. Some staging of quail has been performed but this has been incomplete and variations in descriptions, stages and incubation timings mean that comparisons with the chick are not always easily made. There appears to be general agreement that, at the early stages of embryogenesis, there is little developmental difference between chick and quail embryos, although the basis for this has not been established experimentally. The accelerated ontogeny of quail embryos at mid to late stages of development means that registration with the chick is lost. We have therefore developed a definitive developmental stage series for Japanese quail so that differences are fully characterized, misconceptions or assumptions are avoided, and the results of comparative studies are not distorted.