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  • 1
    In: BMJ Open, BMJ, Vol. 12, No. 2 ( 2022-02), p. e051187-
    Abstract: Successful clinical trials are subject to recruitment. Recently, the REJUVENATE trial, a prospective phase 2a open-label, single-arm interventional clinical trial conducted within the Innovative Medicines Initiative-supported Combatting Bacterial Resistance in Europe-Carbapenem Resistance project, was published, with 85% of the recruitment performed in Spain. We analysed the recruitment success in this trial by establishing a model of recruitment practice. Methods A descriptive qualitative study was performed from May 2016 to October 2017 at 10 participating Spanish centres. Data were extracted from: (1) feasibility questionnaires to assess the centre’s potential for patient enrolment; (2) delegation of responsibility records; (3) pre-screening records including an anonymised list of potentially eligible and (4) screening and enrolment records. A descriptive analysis of the features was performed by the participating centre. Pearson’s and Spearman’s correlation coefficients were calculated to determine factors of recruitment success. Results The highest recruitment rate was observed in Hospitals 3 and 6 (58.8 and 47.0 patients per month, respectively). All the study teams were multidisciplinary with a median of 15 members (range: 7–22). Only Hospitals 3, 5 and 6 had dedicated nursing staff appointed exclusively to this study. Moreover, in those three hospitals and in Hospital 9, the study coordinator performed exclusive functions as a research planner, and did not assume these functions for the other hospitals. The univariate analysis showed a significant association between recruitment success and months of recruitment (p=0.024), number of staff (p 〈 0.001), higher number of pharmacists (p=0.005), infectious disease specialists (p 〈 0.001), the presence of microbiologist in the research team (p=0.018) and specifically dedicated nursing staff (p=0.036). Conclusions The existence of broad multidisciplinary teams with staff dedicated exclusively to the study as well as the implementation of a well-designed local patient assessment strategy were the essential optimisation factors for recruitment success in Spain. Trial registration number NCT02655419 ; EudraCT 2015-002726-39; analysis of pre-screened patients.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 2
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 976.2-976
    Abstract: The present study analyzes the added value of quantification by MRI of SI joints by comparing it to the standard interpretation with ASAS criteria for the classification of patients with axSpA of recent onset and a six-year follow-up. Objectives: To evaluate if the quantification of bone marrow edema (BME) of the sacroiliac (SI) joints by magnetic resonance imaging (MRI) improves capacity for axial spondyloarthritis (axSpA) classification in comparison to the assessment of sacroiliitis by means of ASAS classification criteria. Methods: Prospective study from the ESPeranza cohort involving 66 subjects with an available MRI of the SI joints at baseline. This subgroup includes patients with axSpA (n=28), peripheral spondyloarthritis (n=10) and a group with other diagnoses that were not spondyloarthritis (n=28). Measures of diagnostic usefulness (area under the curve (AUC), sensitivity, specificity, Youden’s J statistic, LR+ and LR-) were calculated for MRI of the SI joints according to ASAS criteria and for MRI quantified by means of SCAISS (Spanish tool for semi-automatic quantification of sacroiliac inflammation by MRI in spondyloarthritis). This analysis was stratified in patients who were HLA-B27 positive and negative. Results: Out of a total of 66 MRI of the SI joints, 20 (30.3%) were positive according to ASAS criteria. Out of these 20 subjects, 18 patients with final diagnosis of axSpA had a positive MRI, and 2 patients did not have axSpA. Out of the 66 patients of the cohort, 23 (34.8%) patients were HLA-B27 positive and 42 (63,6%) were negative. AUC value with bone marrow edema (BME) quantification was 0.919 (CI95% 0.799-1) for HLA-B27 positive patients and 0.884 (CI95% 0.764-1) for HLA-B27 negative patients. A SCAISS cutoff point of 80 units obtained a specificity of 94.4% and LR+ 7.5, while assessment by ASAS criteria showed a specificity value of 90% and LR+ 6.4. Conclusion: For patients with suspected axSpA, quantification of BME improves the predictive capacity of MRI of the SI joints, for both HLA-B27 positive and negative patients. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    RVK:
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 1481557-6
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