I wrote up a page about "Lasagna's Law" that offers a few insights:
--> http://www.pmean.com/11/lasagna.html
I mention on that page that poor accrual is typically attributed to
very narrow inclusion criteria, high refusal rates among patients, and
insufficient resources to approach eligible patients.
I would also argue that poor planning and monitoring is at fault, and
I'm working on a Bayesian model for patient accrual. The model requires
specification of a prior distribution, and this forces the researcher
to think about the uncertainties associated with this particular study.
As actual accrual data appears, you can update the prior with this data
and get a more realistic forecast. Hopefully, this will allow
researchers to make early corrections to a slow accruing study while it
is still possible to get it back on track. I have a series of webpages
about this at:
--> http://www.pmean.com/category/AccrualProblems.html
and I'm hoping to submit an NIH grant to get more worked funded in this
area.
Steve Simon, [log in to unmask], Standard Disclaimer.
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On 1/8/2012 9:20 PM, Djulbegovic, Benjamin wrote:
> Dear colleagues, There have been numerous studies on the reasons for
> poor accrual in clinical trials. I am looking for one page (1-2
> slides) summary of the most common reasons for poor
> accrual/recruitments of patients/participants in clinical trials.
> (Somehow, I remember that the most common reason for poor accrual is
> the lack of trials answering relevant question for the patients, but
> I seem not to be able to locate the reference- any help will be very
> much appreciated). Thank you in advance for all help you can offer.
> Ben Djulbegovic
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