Involving patients and the public In sTatistIcal Analysis pLans (INITIAL): A delphi survey

Beatriz Goulao* (Corresponding Author), Tim Morris

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Patient and public involvement (PPI) in trials aims to enhance research by improving its relevance and transparency. Planning for statistical analysis begins at the design stage of a trial within the protocol and is refined and detailed in a Statistical Analysis Plan (SAP). While PPI is common in design and protocol development it is less common within SAPs. This study aimed to reach consensus on the most important and relevant statistical analysis items within an SAP to involve patients and the public.

METHODS: We developed a UK-based, two-round Delphi survey through an iterative consultation with public partners, statisticians, and trialists. The consultation process started with 55 items from international guidance for statistical analysis plans. We aimed to recruit at least 20 participants per key stakeholder group for inclusion in the final analysis of the Delphi survey. Participants were asked to vote on each item using a Likert scale from 1 to 9, where a rating of 1 to 3 was labelled as having 'limited importance'; 4 to 6 as 'important but not critical' and 7 to 9 as 'critical' to involve patients and the public. Results from the second round determined consensus on critical items for PPI.

RESULTS: The consultation exercise led to the inclusion of 15 statistical items in the Delphi survey. We recruited 179 participants, of whom 72% (129: 36 statisticians, 29 patients or public partners, 25 clinical researchers or methodologists, 27 trial managers, and 12 PPI coordinators) completed both rounds. Participants were on average 48 years old, 60% were female, 84% were White, 64% were based in England and 84% had at least five years' experience in trials. Four items reached consensus regarding critical importance for patient and public involvement: presentation of results to trial participants; summary and presentation of harms; interpretation and presentation of findings in an academic setting; factors impacting how well a treatment works. No consensus was reached for the remaining 11 items. In general, the results were consistent across stakeholder groups.

DISCUSSION: We identified four critical items to involve patients and the public in statistical analysis plans. The remaining 11 items did not reach consensus and need to be considered in a case-by-case basis with most responders considering patient and public involvement important (but not critical). Our research provides a platform to enable focused future efforts to improve patient and public involvement in trials and enhance the relevance of statistical analyses to patients and the public.

Original languageEnglish
Pages (from-to)e0292257
JournalPloS ONE
Volume18
Issue number12
DOIs
Publication statusPublished - 14 Dec 2023

Bibliographical note

Funding

Our project was funded by the MRC/NIHR Trials Methodology Research Partnership grant TMRP/WG/12. Tim P. Morris was funded by MRC grants MC_UU_00004/07 and MC_UU_00004/09. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Acknowledgments
We would like to thank all participants that took time to reply to our Delphi survey. We would also like to thank all participants that participated in the consultation process or made suggestions to the accompanying blog. They helped us develop the survey and improve its clarity. We would like to thank Clare Robertson for her helpful support during the Delphi’s survey set-up stage, and Karen Beveridge for her support in the organisation of the study.

Data Availability Statement

The raw data is available from the corresponding author or the Health Services Research Unit at the University of Aberdeen, as the data controller, upon request (hsru@abdn.ac.uk). The access to raw data is restricted as the data is potentially identifiable. This follows what is outlined in our protocol approved by the School of Medicine, Medical Sciences and Nutrition Ethics Review Board (SERB).

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