Review and Assessment of Network Meta-analyses for Knowledge Uptake Study (RANK)

Review and Assessment of Network Meta-analyses for Knowledge Uptake (RANK) Study

This randomized controlled trial will assess the interpretability of the rank-heat plot for presenting the results of network meta-analysis in comparison to SUCRA (surface under the cumulative ranking) plots which are suggested to present one of the best ranking statistics.

Study Overview

• Status: Withdrawn
• Conditions: Clinical Decision-making
• Intervention / Treatment: Other: Rank-Heat Plot; Other: SUCRA Plot

Detailed Description

Clinicians are responsible for making decisions to improve health outcomes. When available, clinicians should use the results of a knowledge synthesis, such as systematic reviews and meta-analyses, to inform decision-making. Pairwise meta-analyses are limited, however, by the availability of RCTs that directly compare interventions. This is troublesome for knowledge users who require results from comparisons of multiple interventions to inform decision-making. To address this concern, the use of network meta-analyses (NMAs) is increasing in healthcare the literature. NMAs are a useful tool because they can summarize results from numerous studies and interventions. It is unclear how NMA results should be presented to increase the likelihood of clinicians understanding and using the results to improve health outcomes. Thus, a randomized controlled trial of NMA plots will be conducted. Participants will be randomized to either the rank-heat plot (intervention) or SUCRA plots (control) that present the same NMA results of a study that explored the effectiveness of quality improvement interventions for falls prevention. Outcomes will be ascertained via an online survey. The RCT will take place in an online environment and will require each participant to partake in a single session. This study will help guide best practices for the presentation of reviews to improve the uptake and use of NMA.

• Study Type: Interventional
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Clinicians must be accredited to practice in Canada and working (full- or part-time) as a family physician or general internist.

Exclusion Criteria:

• Unable to read and understand English;
• No access to the internet;
• Read, co-authored or peer-reviewed the study: "Quality Improvement strategies to Prevent Falls in the Elderly: A systematic review and network meta-analysis" (manuscript in preparation).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Rank-Heat Plot; The intervention group will receive an online survey to evaluate their interpretation of the results from the NMA with a rank-heat plot including results from 2 outcomes that were selected by our knowledge users (#injurious falls, #fractures).	Other: Rank-Heat Plot; provides a visual presentation of treatment hierarchy across multiple outcomes
Active Comparator: SUCRA (surface under the cumulative ranking) Plot; The control group will receive an online survey to evaluate their interpretation of the results from the NMA with the SUCRA plots including results from the same 2 outcomes that will be presented to the intervention group (i.e., #injurious falls, #fractures).	Other: SUCRA Plot; provides a visual presentation of treatment ranking for a single outcome.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Proportion of participants who appropriately define the clinical "bottom line." Participants' answers will be independently evaluated by two investigators for agreement with an expert panel's recommendation.	during experiment via single session, <1 hour survey

Secondary Outcome Measures

Outcome Measure	Time Frame
Proportion of participants who accurately apply the evidence to the provided clinical scenario.	during experiment via single session, <1 hour survey
Completeness of survey data evaluated by two independent investigators	Immediate post-experiment
Time taken to complete survey	Immediate post-experiment

Collaborators and Investigators

• Sponsor: Unity Health Toronto

Study record dates

Study Major Dates

• Study Start (Anticipated): July 1, 2019
• Primary Completion (Anticipated): January 1, 2021
• Study Completion (Anticipated): January 1, 2021

Study Registration Dates

• First Submitted: September 11, 2017
• First Submitted That Met QC Criteria: September 12, 2017
• First Posted (Actual): September 14, 2017

Study Record Updates

• Last Update Posted (Actual): April 4, 2019
• Last Update Submitted That Met QC Criteria: April 2, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Other Study ID Numbers: 17-0107

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No