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Attrition in NRG Oncology's Radiation-Based Clinical Trials. | LitMetric

AI Article Synopsis

  • - The study analyzed 27,443 patients from 134 radiation-based clinical trials to identify factors that lead to attrition (dropout) during these clinical studies, using data from trials conducted between 1985 and 2011.
  • - Most patients were part of event-driven trials, which had significantly lower attrition rates compared to fixed-time trials, with factors like younger age and female gender linked to higher dropout rates.
  • - Understanding these attrition factors can help improve patient retention strategies, focusing on patient demographics and trial types, as well as regional influences across the U.S.

Article Abstract

Purpose: To determine individual, organizational, and protocol-specific factors associated with attrition in NRG Oncology's radiation-based clinical trials.

Methods And Materials: This retrospective analysis included 27,443 patients representing 134 NRG Oncology's radiation-based clinical trials .trials with primary efficacy results published from 1985-2011. Trials were separated on the basis of the primary endpoint (fixed time vs event driven). The cumulative incidence approach was used to estimate time to attrition, and cause-specific Cox proportional hazards models were used to assess factors associated with attrition.

Results: Most patients (69%) were enrolled in an event-driven trial (n = 18,809), while 31% were enrolled in a fixed-time trial (n = 8634). Median follow-up time for patients enrolled in fixed-time trials was 4.1 months and 37.2 months for patients enrolled in event-driven trials. Fixed time trials with a duration < 6 months had a 5 month attrition rate of 4.3% (95% confidence interval [CI]: 3.4%, 5.5%) and those with a duration ≥ 6 months had a 1 year attrition rate of 1.6% (95% CI: 1.2, 2.1). Event-driven trials had 1- and 5-year attrition rates of 0.5% (95% CI: 0.4%, 0.6%) and 13.6% (95% CI: 13.1%, 14.1%), respectively. Younger age, female gender, and Zubrod performance status >0 were associated with greater attrition as were enrollment by institutions in the West and South regions and participation in fixed-time trials.

Conclusions: Attrition in clinical trials can have a negative effect on trial outcomes. Data on factors associated with attrition can help guide the development of strategies to enhance retention. These strategies should focus on patient characteristics associated with attrition in both fixed-time and event-driven trials as well as in differing geographic regions of the country.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339529PMC
http://dx.doi.org/10.1016/j.ijrobp.2018.04.078DOI Listing

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