Title

Boosting enrollment in neurology trials with Local Identification and Outreach Networks (LIONs).

Document Type

Article

Abstract

OBJECTIVE: Our purpose was to develop a geographically localized, multi-institution strategy for improving enrolment in a trial of secondary stroke prevention.

METHODS: We invited 11 Connecticut hospitals to participate in a project named the Local Identification and Outreach Network (LION). Each hospital provided the names of patients with stroke or TIA, identified from electronic admission or discharge logs, to researchers at a central coordinating center. After obtaining permission from personal physicians, researchers contacted each patient to describe the study, screen for eligibility, and set up a home visit for consent. Researchers traveled throughout the state to enroll and follow participants. Outside the LION, investigators identified trial participants using conventional recruitment strategies. We compared recruitment success for the LION and other sites using data from January 1, 2005, through June 30, 2007.

RESULTS: The average monthly randomization rate from the LION was 4.0 participants, compared with 0.46 at 104 other Insulin Resistance Intervention after Stroke (IRIS) sites. The LION randomized on average 1.52/1,000 beds/month, compared with 0.76/1,000 beds/month at other IRIS sites (p = 0.03). The average cost to randomize and follow one participant was $8,697 for the LION, compared with $7,198 for other sites.

CONCLUSION: A geographically based network of institutions, served by a central coordinating center, randomized substantially more patients per month compared with sites outside of the network. The high enrollment rate was a result of surveillance at multiple institutions and greater productivity at each institution. Although the cost per patient was higher for the network, compared with nonnetwork sites, cost savings could result from more rapid completion of research.

Keywords

Clinical Trials as Topic, Connecticut, Hospitals, Community, Humans, Informed Consent, Insulin Resistance, Ischemic Attack, Transient, Multicenter Studies as Topic, Nervous System Diseases, Neurology, Patient Selection, Random Allocation, Stroke

Medical Subject Headings

Clinical Trials as Topic; Connecticut; Hospitals, Community; Humans; Informed Consent; Insulin Resistance; Ischemic Attack, Transient; Multicenter Studies as Topic; Nervous System Diseases; Neurology; Patient Selection; Random Allocation; Stroke

Publication Date

4-14-2009

Publication Title

Neurology

ISSN

1526-632X

Volume

72

Issue

15

First Page

1345

Last Page

1351

PubMed ID

19365056

Digital Object Identifier (DOI)

10.1212/wnl.0b013e3181a0fda3

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