Does recruitment for multicenter clinical trials improve dissemination and timely implementation of their results? A survey study from the Netherlands

Abstract

BACKGROUND Results from clinical trials are often slowly implemented. We studied whether participation in multicenter clinical trials improves reported dissemination, convincement, and subsequent implementation of its results. METHODS We sent a web-based questionnaire to gynecologists, residents, nurses, and midwives in all obstetrics and gynecology departments in the Netherlands. For nine trials in perinatology, reproductive medicine, and gynecologic oncology, we asked the respondents whether they had knowledge of the results, were convinced by the results, and what percentage of their patients were treated according to the results of these trials. We compared the level of knowledge, convincement, and reported implementation of results in practice for the nine trials for respondents who worked in hospitals that had recruited for a trial with respondents who worked in a hospital that had not recruited for that trial. The reported implementation was restricted to six trials that showed decisive results. RESULTS We analyzed 202 questionnaires from 83 departments in obstetrics and gynecology in the Netherlands (93% of all departments). The percentage of respondents who had worked in a hospital that recruited for a specific study varied between 8% and 71% per study and was 28% on average. The relative risk (RR) for knowledge of the study result for respondents who had worked in a recruiting hospital was for all studies positive and varied between 1.1 and 3.3 (pooled RR: 1.8, 95% confidence interval (CI): 1.7–1.9). In general, health-care workers were convinced of trial results, independent of whether they had worked in a hospital that recruited for a trial or not (pooled RR: 1.02, 95% CI: 0.99–1.05). Reported implementation of trial’s results, that is, less than 20% were treated with unfavorable treatment according to study results, was better in hospitals that had recruited for those trials (pooled RR: 1.1, 95% CI: 1.02–1.19). CONCLUSION Participation in these multicenter clinical trials was associated with better knowledge about the trial’s results, with a minor improvement of the reported implementation of the study results.