Randomised Controlled Trials in Family Practice – learn how in 3.5 hours!
Nov 25th, 2012 by Martin Dawes
Yesterday the sunshine was here and yet our department boardroom was full of people who had still found the enthusiasm and keenness to attend a workshop. This was designed to give people hands on experience of designing a randomised controlled trial for family practice. It started with Raina Elley (Peter Wall Institute Visiting fellow) giving us the methods of design, methods to avoid bias, and the steps to actually do this for real in an excellent presentation answering plenty of questions as she went along. Then we were split into three groups and over the next hour or so developed a trial. We all competed for the best acronym, produce a rationale for a trial, developed the aims and wrote a study question. We develooped the design, described the particiapnts, the intervention and the control. We had plenty of discussion over outcome measures, agreed the duration of the study, and looked at the the methods of randomisation, allocation, concealment and blinding. Finally we addressed the strengths and weaknesses of our design. In the workshops were those who had undertaken RCT’s, people thinking of doing them, and people starting with a question. By 12.30 the three groups had each given a five minute presentation. It was a remarkable workshop revealing Raina’s strengths as a teacher, facilitator and trialist. She is heading off to the North American Primary Care Research Workshop where she will give the workshop again, helped this time by our previous research director, now chair of research at University of Montreal, Janusz Kaczorowski. If you are in New Orleans on Saturday for NAPCRG then I recommend making time for this workshop if you can.
Raina is returning to New Zealand after three months in the department. During that time she has applied for and gained ethics for a study to test a New Zealand tool called CHAT, identified the two practices, recruited the patients and delivered the tool. The Case-finding Health Assessment Tool (CHAT), a short self-administered tool for life-style and mental health assessment of adult (19 years and over) patients in Family Practice, has been developed by a multi-disciplinary team (including the fields of Family Practice, nursing and psychology) from the University of Auckland in New Zealand, led by Prof Goodyear-Smith. The tool assesses for risky behaviours (smoking, drinking, other drug use, gambling, abuse, physical inactivity) and mental health issues (depression, anxiety, anger control) in Family Practice. For each item patients are asked whether this is something with which they would like help, either during this consultation or at a later date. From the two practice 171 patients completed the tool and the responses are now being evaluated. This demonstrates what can be done but especially reflects Raina’s enthusiasm for answering primary care questions that are highly relevant to the health professionals and patients.
During her stay she has helped many faculty with research protocol design, worked on collaborative projects, and given several teaching sessions including this workshop. We owe a debt of gratitude to the Peter Wall Institute for supporting her fellowship and to Raina for everything she has helped with over the last three months.
Martin