Browsing by Author "Thomas, Megan"

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    The Application of Preference Elicitation Methods in Clinical Trial Design to Quantify Trade-Offs: A Scoping Review
    (Adis, Springer, Bloomberg School of Public Health, 2021-12-20) Thomas, Megan; Marshall, Deborah A; Choudhary, Daksh; Bartlett, Susan J; Sanchez, Adalberto Loyola; Hazlewood, Glen S
    Background and Objective: Patients can express preferences for different treatment options in a healthcare context, which can be measured with quantitative preference elicitation methods. Our objective was to conduct a scoping review to determine how preference elicitation methods have been used to design clinical trials. Methods: We conducted a scoping review to identify primary research studies involving any health condition, that used quantitative preference elicitation methods, including direct utility-based approaches, and stated preference studies, to value heath trade-offs in the context of clinical trial design. Studies were identified by screening existing systematic and scoping reviews, and a primary literature search in MEDLINE from 2010-present. We extracted study characteristics and the application of preference elicitation methods to clinical trial design according to the SPIRIT checklist from primary studies and summarized the findings descriptively. Results: We identified 18 eligible studies. The included studies applied patient preferences to 5 areas of clinical trial design: intervention selection (n=1), designing N-of-1 trials (n=1), outcome selection and weighting composite and ordinal outcomes (n=12), sample size calculations (n=2), and recruitment (n=2). Using preference elicitation methods led to different decisions being made, such as using preference-weighted composite outcomes instead of equally weighted composite outcomes. Conclusion: Preference elicitation methods are infrequently used to design clinical trials but may lead to changes throughout the trial which could impact the evidence generated. Future work should be done to consider measurement challenges and explore stakeholder perceptions.
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    Crowdsourcing trainees in a living systematic review provided valuable experiential learning opportunities: A mixed-methods study
    (2022-03-29) Lee, Chloe; Thomas, Megan; Ejaredar, null; Kassam, Aliya; Whittle, Samuel L; Buchbinder, Rachelle; Tugwell, Peter; Wells, George; Pardo, Jordi Pardo; Hazlewood, Glen S
    Objective: To understand trainee experiences of participating in a living systematic review (LSR) for rheumatoid arthritis, and the potential benefits in terms of experiential evidence-based medicine (EBM) education. Study Design and Setting: We conducted a mixed-methods study with trainees that participated in the LSR who were recruited broadly from training programs in two countries. Trainees received task-specific training and completed one or more tasks in the review: assessing article eligibility, data extraction, quality assessment. Trainees completed a survey followed by a 1-on-1 interview. Data were triangulated to produce broad themes. Results: Twenty-one trainees, most of whom had little prior experience with systematic reviews, reported a positive overall experience. Key benefits included learning opportunities, task segmentation (ability to focus on a single task, as opposed to an entire review), working in a supportive environment, international collaboration, and incentives such as authorship or acknowledgement. Trainees reported improvement in their competency as a Scholar, Collaborator, Leader, and Medical Expert. Challenges included communication and technical difficulties, and appropriate matching of tasks to trainee skillsets. Conclusion: Participating in a LSR provided benefits to a wide range of trainees and may provide an opportunity for experiential EBM training, while helping LSR sustainability.
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    Patient preferences to value health outcomes in rheumatology clinical trials: Report from the OMERACT special interest group
    (Oxford University Press, British Society for Rheumatology, 2021-05-24) Thomas, Megan; Fraenkel, Liana; Boonen, Annelies; Bansback, Nick; Buchbinder, Rachelle; Marshall, Deborah; Proulx, Laurie; Voshaar, Marieke; Richards, Pamela; Richards, Dawn P; Hiligsmann, Mickael; Guillemin, Francis; Shea, Beverly; Tugwell, Peter; Hazlewood, Glen
    Objective. To inform a research plan for future studies by obtaining stakeholder input on the application of preference-based methods to clinical trial design. Methods. We conducted a virtual OMERACT session to encourage stakeholder engagement. We developed materials for the session to facilitate discussion based on identified case examples and feedback sessions. Results. Participants prioritized incorporating patient preferences in all aspects of trial design with an emphasis on outcome selection. Participants highlighted the need for careful consideration around preference heterogeneity and equity factors. Conclusion. Including patient preferences in trial design was considered a priority requiring further exploration to develop comprehensive guidance.