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      Dental practitioner recruitment for a randomized clinical trial in the field to evaluate the performance of a new glass ionomer restoration material

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          Abstract

          Background

          In 2009, we began recruiting dental practitioners across Germany to participate in a clinical trial to evaluate the clinical performance of EQUIA, a new glass ionomer restoration material. The aim of this paper is to discuss the outcomes of the dental practitioner recruitment and outline the process of establishing a practice-based research network.

          Methods

          Study proposals were sent to randomly selected dental offices in 29 cities in Germany. The proposals were sent until a minimum of 10 clinics in each city declared participation. Later on, briefing lectures informed the participating practitioners about the design, methods, and material application procedure. Participants were familiarized with the guidelines of Good Manufacturing Practice (GMP) and Good Epidemiological Practice (GEP). A questionnaire describing the characteristics of each dental office was filled out by the participating practitioner. Additionally, participation levels were characterized according to the socioeconomic status and geographic districts of residence in Germany (Regions 0 to 9). The associations between the characteristics were tested by the Kruskal-Wallis Test and Chi-squared test ( P < 0.05).

          Results

          A total of 3194 private dental clinics were invited, 1712 clinics refused to participate, 1195 did not respond to the invitation, and 323 agreed to participate. Only 144 clinics participated in the lectures held in their cities and signed the participation agreement. Based on their geographic location, the highest participation was in Region 2 with a participation rate of 14.3 %, and the lowest participation was in Region 6 with a participation rate of 1.7 %. Regions with the lowest rate of unemployment and relatively higher rates of income (Regions 7 and 8) had the highest rate of refusals (86 %).

          Conclusion

          The initial results of the dental practitioner recruitment in this study suggest that the recruitment and pre-randomization design were successful, and by reaching out to a considerable number of private dental clinics to participate, we were able to recruit a smaller number of highly motivated dentists in this clinical study. Regional differences in socioeconomic status, practitioner specialization, and differences in patient health care insurance have to be considered when recruiting dental practitioners for clinical trials.

          Trial registration

          The trial has been registered at Deutsches Register Klinischer Studien (German register of clinical trials) on 6 September 2012 under DRKS-ID: DRKS00004220.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13063-016-1198-3) contains supplementary material, which is available to authorized users.

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          Most cited references30

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          Nonresponse Rates and Nonresponse Bias in Household Surveys

          R. Groves (2006)
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            What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies

            Background A commonly reported problem with the conduct of multicentre randomised controlled trials (RCTs) is that recruitment is often slower or more difficult than expected, with many trials failing to reach their planned sample size within the timescale and funding originally envisaged. The aim of this study was to explore factors that may have been associated with good and poor recruitment in a cohort of multicentre trials funded by two public bodies: the UK Medical Research Council (MRC) and the Health Technology Assessment (HTA) Programme. Methods The cohort of trials was identified from the administrative databases held by the two funding bodies. 114 trials that recruited participants between 1994 and 2002 met the inclusion criteria. The full scientific applications and subsequent trial reports submitted by the trial teams to the funders provided the principal data sources. Associations between trial characteristics and recruitment success were tested using the Chi-squared test, or Fisher's exact test where appropriate. Results Less than a third (31%) of the trials achieved their original recruitment target and half (53%) were awarded an extension. The proportion achieving targets did not appear to improve over time. The overall start to recruitment was delayed in 47 (41%) trials and early recruitment problems were identified in 77 (63%) trials. The inter-relationship between trial features and recruitment success was complex. A variety of strategies were employed to try to increase recruitment, but their success could not be assessed. Conclusion Recruitment problems are complex and challenging. Many of the trials in the cohort experienced recruitment difficulties. Trials often required extended recruitment periods (sometimes supported by additional funds). While this is of continuing concern, success in addressing the trial question may be more important than recruitment alone.
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              Survey among 78 studies showed that Lasagna's law holds in Dutch primary care research.

              Research in general practice has grown considerably over the past decades, but many projects face problems when recruiting patients. Lasagna's Law states that medical investigators overestimate the number of patients available for a research study. We aimed to assess factors related to success or failure of recruitment in general practice research. Survey among investigators involved in primary care research in The Netherlands. Face-to-face interviews were held with investigators of 78 projects, assessing study design and fieldwork characteristics as well as success of patient recruitment. Studies that focused on prevalent cases were more successful than studies that required incident cases. Studies in which the general practitioner (GP) had to be alert during consultations were less successful. When the GP or practice assistant was the first to inform the patient about the study, patient recruitment was less successful than when the patient received a letter by mail. There was a strong association among these three factors. Lasagna's Law also holds in Dutch primary care research: many studies face recruitment problems. Awareness of study characteristics affecting participation of GPs and patients may help investigators to improve their study design.
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                Author and article information

                Contributors
                klinke@uni-greifswald.de
                +3834-8671 40 , daboula@uni-greifswald.de
                schwahn@uni-greifswald.de
                rankbg@med.uni-marburg.de
                hickel@dent.med.uni-muenchen.de
                biffar@uni-greifswald.de
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                10 February 2016
                10 February 2016
                2016
                : 17
                : 73
                Affiliations
                [ ]Policlinic of Prosthodontics and Biomaterials, Greifswald University, Greifswald, Germany
                [ ]Conservative Dentistry Department, Philipps University of Marburg, Marburg, Germany
                [ ]Policlinic for Restorative Dentistry and Periodontology, University of Munich, Munich, Germany
                Article
                1198
                10.1186/s13063-016-1198-3
                4748549
                26861942
                31e68cd5-3804-485c-85ca-7f51fc93d962
                © Klinke et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 July 2014
                : 26 January 2016
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Medicine
                dental restoration,glass ionomer,multicenter study,personnel recruitment
                Medicine
                dental restoration, glass ionomer, multicenter study, personnel recruitment

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