Christiaan F Stolper, Margje W J Van de Wiel, Henrica C W De Vet, Alexander L B Rutten, Paul Van Royen, Marloes A Van Bokhoven, Trudy Van der Weijden, Geert Jan Dinant
Family physicians' diagnostic gut feelings are measurable: construct validation of a questionnaire
BMC family practice
anticipated recruitment cavernous malformations randomised effectiveness care pilot randomised trial would challenging trial compared medical management surgery neurosurgical resection stereotactic radiosurgery medical management alone people symptomatic cerebral cavernous malformation isrctn41647111 previous trials comparing surgical medical management intracranial vascular malformations failed recruit target quintet recruitment intervention integrated trial accrual september 2021april 2023 inclusive improve informed consent recruitment quintet recruitment intervention combined iterative collection analysis quantitative data 28 trial site screening logs recording numbersproportions screened eligible approached randomised qualitative data 79 audiorecorded recruitment discussions 19 interviews healthcare professionals 11 interviews patients 2 investigator workshops observations study meetings subject thematic content conversation analysis triangulated quantitative qualitative data identify barriers facilitators recruitment arose working chief investigators trial management group addressed barriers facilitators corresponding actions improve informed consent recruitment barriers identified included usual care practices made equipoise challenging multidisciplinary teams sometimes overrode recruiter equipoise logistical issues rendered symptomatic cavernoma diagnosis assessment stereotactic radiosurgery challenging facilitators identified included preparedness neurosurgeons offer surgery people otherwise offered medical management alone multidisciplinary team equipoise effective information provision presenting participation solution equipoise regarding management actions recruitment improve inclusivity site screening approach effectiveness information provision resulted 72 participants recruited following 5month extension exceeding target 60 participants quintet recruitment intervention insights revealed barriers facilitators enabling identification remedial actions recruitment definitive trial would benefit trainingsupport encourage clinicians comfortable approaching patients medical management usually offered broadening pool neurosurgeons multidisciplinary team members prepared offer surgery particularly stereotactic radiosurgery national institute health care research