CONSORT 2010 statement: extension to randomised pilot and feasibility trials

Sandra M Eldridge, Claire L Chan, Michael J Campbell, Christine M Bond, Sally Hopewell, Lehana Thabane, Gillian A Lancaster, PAFS consensus group, Sandra M Eldridge, Claire L Chan, Michael J Campbell, Christine M Bond, Sally Hopewell, Lehana Thabane, Gillian A Lancaster, PAFS consensus group

Abstract

The Consolidated Standards of Reporting Trials (CONSORT) statement is a guideline designed to improve the transparency and quality of the reporting of randomised controlled trials (RCTs). In this article we present an extension to that statement for randomised pilot and feasibility trials conducted in advance of a future definitive RCT. The checklist applies to any randomised study in which a future definitive RCT, or part of it, is conducted on a smaller scale, regardless of its design (eg, cluster, factorial, crossover) or the terms used by authors to describe the study (eg, pilot, feasibility, trial, study). The extension does not directly apply to internal pilot studies built into the design of a main trial, non-randomised pilot and feasibility studies, or phase II studies, but these studies all have some similarities to randomised pilot and feasibility studies and so many of the principles might also apply.

The development of the extension was motivated by the growing number of studies described as feasibility or pilot studies and by research that has identified weaknesses in their reporting and conduct. We followed recommended good practice to develop the extension, including carrying out a Delphi survey, holding a consensus meeting and research team meetings, and piloting the checklist.

The aims and objectives of pilot and feasibility randomised studies differ from those of other randomised trials. Consequently, although much of the information to be reported in these trials is similar to those in randomised controlled trials (RCTs) assessing effectiveness and efficacy, there are some key differences in the type of information and in the appropriate interpretation of standard CONSORT reporting items. We have retained some of the original CONSORT statement items, but most have been adapted, some removed, and new items added. The new items cover how participants were identified and consent obtained; if applicable, the prespecified criteria used to judge whether or how to proceed with a future definitive RCT; if relevant, other important unintended consequences; implications for progression from pilot to future definitive RCT, including any proposed amendments; and ethical approval or approval by a research review committee confirmed with a reference number.

This article includes the 26 item checklist, a separate checklist for the abstract, a template for a CONSORT flowchart for these studies, and an explanation of the changes made and supporting examples. We believe that routine use of this proposed extension to the CONSORT statement will result in improvements in the reporting of pilot trials.

Editor’s note: In order to encourage its wide dissemination this article is freely accessible on the BMJ and Pilot and Feasibility Studies journal websites.

Conflict of interest statement

All authors have completed the ICMJE disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare support from the following organisations for the submitted work—Queen Mary University of London, University of Sheffield (ScHARR Research Committee Pump priming grant), NIHR Research Design Services London and South East, NIHR Statisticians Group, Chief Scientist Office Scotland. GAL is editor in chief of the new BioMed central journal Pilot and Feasibility Studies proposed by Daniel R Shanahan, which was created out of this work. Daniel R Shanahan is employed by BioMed Central, and Trish Groves is an editor of the BMJ. SME, CMB, MJC, and LT are on the editorial board of Pilot and Feasibility Studies and CLC is an associate editor. Frank Bretz works for Novartis. The authors declare no other competing interests. None of the listed people involved in either journal played any part in the peer review process or editorial decision making.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5076380/bin/elds033598.f1_default.jpg
Fig 1 Example of abstract for report of pilot trial, shown alongside CONSORT for abstracts extension for pilot randomised trials
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5076380/bin/elds033598.f2_default.jpg
Fig 2 Revised version of example abstract for report of pilot trial, shown alongside CONSORT for abstracts extension for pilot randomised trials
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5076380/bin/elds033598.f3_default.jpg
Fig 3 Track changes version of example abstract for report of pilot trial, showing changes between figures 1 and 2
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5076380/bin/elds033598.f4_default.jpg
Fig 4 Flow diagram of a randomised pilot trial of pharmacist led management of chronic pain in primary care (reproduced from Bruhn et al69)
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5076380/bin/elds033598.f5_default.jpg
Fig 5 Recommended flow diagram of progress through phases of a parallel randomised pilot trial of two groups—that is, screening, enrolment, intervention allocation, follow-up, and assessment for each pilot trial objective. Adapted from Moher et al

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