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. 2018 Nov 16;16(1):210.
doi: 10.1186/s12916-018-1196-2.

Development process of a consensus-driven CONSORT extension for randomised trials using an adaptive design

Munyaradzi Dimairo  1 , Elizabeth Coates  2 , Philip Pallmann  3 , Susan Todd  4 , Steven A Julious  2 , Thomas Jaki  5 , James Wason  6   7 , Adrian P Mander  6 , Christopher J Weir  8 , Franz Koenig  9 , Marc K Walton  10 , Katie Biggs  2 , Jon Nicholl  2 , Toshimitsu Hamasaki  11 , Michael A Proschan  12 , John A Scott  13 , Yuki Ando  14 , Daniel Hind  2 , Douglas G Altman  15
Affiliations

Development process of a consensus-driven CONSORT extension for randomised trials using an adaptive design

Munyaradzi Dimairo et al. BMC Med. .

Abstract

Background: Adequate reporting of adaptive designs (ADs) maximises their potential benefits in the conduct of clinical trials. Transparent reporting can help address some obstacles and concerns relating to the use of ADs. Currently, there are deficiencies in the reporting of AD trials. To overcome this, we have developed a consensus-driven extension to the CONSORT statement for randomised trials using an AD. This paper describes the processes and methods used to develop this extension rather than detailed explanation of the guideline.

Methods: We developed the guideline in seven overlapping stages: 1) Building on prior research to inform the need for a guideline; 2) A scoping literature review to inform future stages; 3) Drafting the first checklist version involving an External Expert Panel; 4) A two-round Delphi process involving international, multidisciplinary, and cross-sector key stakeholders; 5) A consensus meeting to advise which reporting items to retain through voting, and to discuss the structure of what to include in the supporting explanation and elaboration (E&E) document; 6) Refining and finalising the checklist; and 7) Writing-up and dissemination of the E&E document. The CONSORT Executive Group oversaw the entire development process.

Results: Delphi survey response rates were 94/143 (66%), 114/156 (73%), and 79/143 (55%) in rounds 1, 2, and across both rounds, respectively. Twenty-seven delegates from Europe, the USA, and Asia attended the consensus meeting. The main checklist has seven new and nine modified items and six unchanged items with expanded E&E text to clarify further considerations for ADs. The abstract checklist has one new and one modified item together with an unchanged item with expanded E&E text. The E&E document will describe the scope of the guideline, the definition of an AD, and some types of ADs and trial adaptations and explain each reporting item in detail including case studies.

Conclusions: We hope that making the development processes, methods, and all supporting information that aided decision-making transparent will enhance the acceptability and quick uptake of the guideline. This will also help other groups when developing similar CONSORT extensions. The guideline is applicable to all randomised trials with an AD and contains minimum reporting requirements.

Keywords: Adaptive design; CONSORT extension; Flexible design; Randomised controlled trial; Reporting guidance; Reporting guideline.

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Conflict of interest statement

Ethics approval and consent to participate

The project ethics approval was granted by the REC of the ScHARR at the University of Sheffield (ref: 012041). All Delphi participants provided consent online during registration.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Development process of the Adaptive designs Extension CONSORT extension guideline for randomised trials
Fig. 2
Fig. 2
Snapshot of the online round 1 Delphi survey. [N] and [M] represent new and modified reporting items
Fig. 3
Fig. 3
Snapshot of the online Delphi survey for round 2 among round 1 completers. In green are responses of all participants. In blue are the responses of the self-identified stakeholder group at registration which the participant belongs to (clinical trialist, clinical trial user, or methodologist)
Fig. 4
Fig. 4
Round 1 perceptions about the importance of specifying pre-planned adaptations (item 3c). Item descriptor is downloadable at 10.15131/shef.data.6198290
Fig. 5
Fig. 5
Round 1 perceptions about the importance of decision-making criteria to guide adaptation (item 7b). Item descriptor is downloadable at 10.15131/shef.data.6198290
See this image and copyright information in PMC

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