Using systematic reviews to inform NIHR HTA trial planning and design: a retrospective cohort

Sheetal Bhurke · Andrew Cook · Anna Tallant · Amanda J. Young · Elaine Williams · James P. Raftery

24 citations0/0 files storedBMC Medical Research Methodology

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Meta-analysis and systematic reviews Clinical practice guidelines implementation Delphi Technique in Research

Abstract

BACKGROUND: Chalmers and Glasziou's paper published in 2014 recommends research funding bodies should mandate that proposals for additional primary research are built on systematic reviews of existing evidence showing what is already known. Jones et al. identified 11 (23%) of 48 trials funded during 2006-8 by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme did not reference a systematic review. This study did not explore the reasons for trials not referencing a systematic review or consider trials using any other evidence in the absence of a systematic review. Referencing a systematic review may not be possible in certain circumstances, for instance if the systematic review does not address the question being proposed in the trial. The current study extended Jones' study by exploring the reasons for why trials did not reference a systematic review and included a more recent cohort of trials funded in 2013 to determine if there were any changes in the referencing or use of systematic reviews. METHODS: Two cohorts of NIHR HTA randomised controlled trials were included. Cohort I included the same trials as Jones et al. (with the exception of one trial which was discontinued). Cohort II included NIHR HTA trials funded in 2013. Data extraction was undertaken independently by two reviewers using full applications and trial protocols. Descriptive statistics was used and no formal statistical analyses were conducted. RESULTS: Five (11%) trials of the 47 funded during 2006-2008 did not reference a systematic review. These 5 trials had warranted reasons for not referencing systematic reviews. All trials from Cohort II referenced a systematic review. A quarter of all those trials with a preceding systematic review used a different primary outcome than those stated in the reviews. CONCLUSIONS: The NIHR requires that proposals for new primary research are justified by existing evidence and the findings of this study confirm the adherence to this requirement with a high rate of applications using systematic reviews.

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References

2010Clinical trials should begin and end with systematic reviews of relevant evidence: 12 years and waiting 2004Doing New Research? Don't Forget the Old 2005The use of systematic reviews when designing studies 2009Evidence synthesis as the key to more coherent and efficient research 2013The use of systematic reviews in the planning, design and conduct of randomised trials: a retrospective cohort of NIHR HTA funded trials 2010Empirical assessment suggests that existing evidence could be used more fully in designing randomized controlled trials 2014Ability of a meta-analysis to prevent redundant research: systematic review of studies on pain from propofol injection 2013Many reports of randomised trials still don’t begin or end with a systematic review of the relevant evidence

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2016All health researchers should begin their training by preparing at least one systematic review 2021Barriers and Facilitating Factors for Conducting Systematic Evidence Assessments in Academic Clinical Trials 2017The INVEST project: investigating the use of evidence synthesis in the design and analysis of clinical trials 2018Use of a random effects meta‐analysis in the design and analysis of a new clinical trial

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