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Marion Campbell Profile
Marion Campbell

@MarionKCampbell

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Trialist; Statistician; Professor of Health Services Research; University of Aberdeen. Hebridean. Views my own.

Aberdeen
Joined August 2013
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@MarionKCampbell
Marion Campbell
1 year
A clinical trial design that is often misunderstood is the #NonInferiority clinical trial design. 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
Delighted to be the new Chair of @The_MRC @NIHRresearch Better Methods Better Research #BMBR Funding Panel. Robust methods are the bedrock of good science & can make a huge difference to the design/quality of health research. For funding calls see..
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@MarionKCampbell
Marion Campbell
11 months
A year ago I thought it might be fun to start the week with a tweet about some aspect of trial, or related, methodology - which I have tagged with #MethodologyMonday . 50+ topics later, I hope you have found some of them useful … here is a list of the topics covered so far 1/
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@MarionKCampbell
Marion Campbell
8 months
Last week I said that only randomised data can give truly unbiased effect estimates - this is because observational (real-world) data are affected by #SelectionBias which can skew results. A few more thoughts on this 1/8 #MethodologyMonday #62
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@MarionKCampbell
Marion Campbell
9 months
Our UK-REBOA trial is out. A huge endeavour with major implications for UK trauma care-showing that use of #REBOA in the ED for exsanguinating haemorrhage did not reduce, and may increase mortality. Huge thanks to the entire trial team. @janjansenuk
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@MarionKCampbell
Marion Campbell
1 year
When we talk about #randomisation we often assume this implies a single common method of allocating participants to treatments, yet there are a variety of alternative approaches used in practice. A recent paper reminds us of this. 1/6 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
I have spoken about the importance of minimally clinically important differences ( #MCID ) before in relation to sample sizes but how do you decide what it should be? There was an interesting paper published this week adding to this literature 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
11 months
We often hear of different analysis approaches to a trial - intention to treat ( #ITT ), per protocol ( #PP ), and other approaches like #AsTreated and #CACE analysis. So how do we work out what to use when? 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
2 years
One of my bugbears came up this week - the so-called “negative” trial. Trials where the overall p-value is >0.05 are not negative trials. There is no such thing as a negative trial - every trial (incl those with p>0.05) adds positively to the evidence base. 1/5 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
2 years
We are all being rightly encouraged to be #efficient in our trial design & conduct. Efficiency comes primarily through design choices … whether classic or more modern efficient designs … a few reflections below 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
3 months
In clinical trials, we sometimes undertake #SensitivityAnalysis alongside the main primary analysis. But when should we use them and to what purpose? 1/8 #MethodologyMonday #80
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@MarionKCampbell
Marion Campbell
8 months
One recurring element in trials that doesn’t seem to go away is #Dichotomisation . This is the arbitrary splitting of continuous data like weight, blood pressure etc into good/bad, high/low etc 1/7 #MethodologyMonday #64
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@MarionKCampbell
Marion Campbell
11 months
It doesn’t matter how innovative or efficient your trial design is, unless your trial is managed well, it will likely not succeed as planned. Having high quality #TrialManagement is a fundamental requirement 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
Delighted and honoured to have been elected a Fellow of the @acmedsci . Health research & clinical trials are the epitome of team science and nothing would be possible without the collective input of so many wonderful colleagues and collaborators!!
@acmedsci
Academy of Medical Sciences
1 year
Congratulations to our new Fellows announced today 👏 Find out more about these outstanding biomedical and health researchers and see the full list on our website: #AMSFellows2023
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@MarionKCampbell
Marion Campbell
9 months
If you wish to use a patient reported outcome measure in your trial, it is important to choose your measure wisely to ensure that you won’t observe #Floor or #Ceiling effects in your data. 1/8 #MethodologyMonday #57
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@MarionKCampbell
Marion Campbell
1 year
Choosing the right outcome is key to a clinical trial. Sometimes a #CompositeOutcome - an outcome that combines more than one dimension into a single measure - is felt to be most appropriate. These can be useful but can be fraught with difficulty 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
9 months
We often talk about the need for a #ProcessEvaluation in a trial (especially in trials of more complex interventions). But what is a Process Evaluation and what does it aim to do? 1/8 #MethodologyMonday #58
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@MarionKCampbell
Marion Campbell
5 months
We are increasingly seeing the use of #RoutineHealthcareData in clinical trials-data routinely collected on healthcare systems as part of standard healthcare delivery ie. not specifically collected for research purposes. But when/how should they be used 1/7 #MethodologyMonday #73
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@MarionKCampbell
Marion Campbell
11 months
It is common to perform #SubgroupAnalysis as part of a trial, but they can be poorly executed & caution is often needed when interpreting them 1/9 #MethodologyMonday #52
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@MarionKCampbell
Marion Campbell
2 years
Fiery sunset @aberdeenuni campus this afternoon
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@MarionKCampbell
Marion Campbell
1 year
#MissingData is a common issue when analysing clinical trials. There are a variety of ways one can treat missing data in the analysis - each have pros & cons 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
While 1:1 randomisation to interventions is most common in clinical trials, sometimes #UnequalRandomisation is used. There are a number of factors that influence which randomisation ratio to use 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
There was an interesting paper this week on different stakeholders understanding of the concept of #equipoise . Equipoise is an essential concept in clinical trials but is often not well understood 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
6 months
It’s always good to start a new year refreshing some basics. All research starts with getting the #ResearchQuestion right. 1/8 #MethodologyMonday #69
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@MarionKCampbell
Marion Campbell
1 year
One of the hardest thing for any trialist is the implementation of their trial findings. This is often exacerbated if the recommendation is to #deimplement a treatment/procedure. There have been some really useful recent papers that will help in this space 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
4 years
Recently I have been reviewing a number of trial protocols. One reflection is the growing trend of noting “we will write a full statistical analysis plan” without giving any further details. The assumption is that this is sufficient ... it is not. 1/6
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@MarionKCampbell
Marion Campbell
10 months
Today marks 30 yrs 😱 since I joined @hsru_aberdeen ! The first studies I worked on then (a cluster trial, a balanced incomplete block design & a surgical trial) fired a lasting passion for research/complex trial design & allowed me to work with amazing people along the way 😊🙏
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@MarionKCampbell
Marion Campbell
4 years
As we digest the #RECOVERY trial findings that hydroxychloroquine shows no benefit for #COVID ー19, I would like to give a big shout out to the trial #DMC who will have wrestled with when was the right time to call a halt. They have met every 2 weeks for the duration. Thank you!!
@MartinLandray
Martin Landray
4 years
Full public statement available here:
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@MarionKCampbell
Marion Campbell
1 year
One trial design that is not so often used is the #nof1 trial. An n-of-1 trial looks at the effectiveness of different interventions for an individual 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
4 years
Great discussion at #CCR20 about how to interpret trials when the primary outcome is not statistically significant. This paper from Stuart Pocock being discussed. Such a good read with excellent questions to ask.
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@MarionKCampbell
Marion Campbell
5 years
Dawn breaking over @aberdeenuni library this morning ...
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@MarionKCampbell
Marion Campbell
4 months
We often use patient reported outcome measures ( #PROMs ) in clinical trials, but it can be difficult to choose which to use. There are several elements that are useful to consider 1/8 #MethodologyMonday #78
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@MarionKCampbell
Marion Campbell
1 year
Pilot & feasibility work can inform whether a trial is likely to deliver. Decisions for #TrialProgression can be based on fairly blunt criteria but deciding whether to progress to a trial is often more complex. A couple of more depth approaches can help 1/10 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
Super day being inducted as a Fellow of the @acmedsci & having the opportunity to join in with the Academy’s 25th anniversary celebrations. Also wonderful to catch up with my co-statistical FMedSci’s @deeksj and @prw_paula 😊 #MedicalStats #FMedSci
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@MarionKCampbell
Marion Campbell
1 year
Last week I mentioned #Bayesian trials in passing when discussing small populations & thought it’d be useful to discuss them a bit more. #Bayesian trials can be extremely useful and have increased in attention over recent years. 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
3 months
Whilst randomisation is crucial to ensure that a clinical trial is a fair test of a treatment, there are a number of potential sources of #Bias that also need to be controlled over the course of a trial 1/8 #MethodologyMonday #81
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@MarionKCampbell
Marion Campbell
1 year
One of the challenges of trials is how best to design them in #SmallPopulations (when the total available n is small). 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
2 years
I have been working on multiple grant applications this week (why do they all come at once!) & been reminded of the fundamental role of the seemingly humble sample size calculation (and how it’s planning can lead to interesting debates). A few thoughts 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
The #FactorialTrial design is one of the very original efficient trial designs yet its potential often remains underused 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
20 days
This tweet was referred to in one of the #CCR24 sessions … so true. We need to move past the simplistic p<0.05 dichotomy!
@tscquizzato
Tommaso Scquizzato, MD
2 years
Study categorisation from @pocock_stuart at #PratoAnaes2022 ➡️ WOW! and PHEW! interpreted the same but very different ➡️ PHEW! and DAMN! interpreted differently but virtually the same We need to get wiser, a p-value is no substitute for brain.
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@MarionKCampbell
Marion Campbell
4 months
I have spoken about “usual care” or “treatment as usual” as a control arm in trials before, but should you ever protocolise usual care or just measure it as is? 1/8 #MethodologyMonday #77
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@MarionKCampbell
Marion Campbell
8 months
I was reminded this week of the phenomenon known as #BuxtonsLaw which can particularly affect clinical trials of devices and surgical procedures 1/8 #MethodologyMonday #61
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@MarionKCampbell
Marion Campbell
2 months
One of the primary elements that should form part of a well-conducted clinical trial is the statistical analysis plan or #SAP 1/7 #MethodologyMonday #84
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@MarionKCampbell
Marion Campbell
1 month
When dealing with complex interventions in clinical trials, you may have to adapt the proposed intervention to your context before evaluation. To do this in a rigorous way the #ADAPT framework can help 1/6 #MethodologyMonday #89
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@MarionKCampbell
Marion Campbell
8 months
Clinical trials is the epitome of #TeamScience involving clinical disciplines, stats, economics, qualitative researchers, behavioural scientists and more. #InterdisciplinaryWorking is stimulating but can be challenging 1/9 #MethodologyMonday #63
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@MarionKCampbell
Marion Campbell
2 months
A word we hear a lot about currently in the trials world is #Estimands .  But what are they and why are they useful? 1/8 #MethodologyMonday #85
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@MarionKCampbell
Marion Campbell
5 years
What an uplifting evening at the Scottish Women’s Awards last night.I was delighted to be nominated for services to medicine.Was fantastic to be alongside so many strong, inspirational and talented women.Many congratulations to all those who were nominated and the worthy winners
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@MarionKCampbell
Marion Campbell
6 years
Our CONSORT guidance on the reporting of stepped wedge trials is now published. Great team effort (led by @karlahemming ) including @GrimshawJeremy @charlesweijer @coryegoldstein @MaryDixonWoods , Monica Taljaard, Andrew Forbes and others.
@bmj_latest
The BMJ
6 years
The stepped wedge cluster randomised trial is increasingly being used. Here's guidance on how to report this important research design
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@MarionKCampbell
Marion Campbell
1 year
This week some of my discussions have centred on #ClusterTrials . Cluster trials involve the randomisation of intact units (wards, hospitals, GP practices etc) rather than individuals. They have a number of key elements that must be accounted for 1/11 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
2 months
A popular, but often misused design, is the #Crossover trial design. But what are the key things to look out for if you are considering using it? 1/9 #MethodologyMonday #87
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@MarionKCampbell
Marion Campbell
10 days
Another issue that came up at #CCR24 was the #WinRatio method - a specific approach to handling composite outcomes in trials. 1/9 #MethodologyMonday #93
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@MarionKCampbell
Marion Campbell
1 year
There was an interesting paper this week detailing a survey of the outcomes of external pilot studies conducted to inform clinical trials. There is often confusion about when/how #pilot & #feasibility studies should be done and what they tell us 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
6 years
Superb talk by Gordon Guyatt on evidence-based medicine. Take home message: Good quality evidence is essential but evidence doesn’t tell you what to do - it needs to be interpreted in the light of patients values and preferences. #trialmethodolgy
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@MarionKCampbell
Marion Campbell
5 years
Delighted to be nominated for this award. Looking forward to celebrating the achievements of women from across Scotland in industry, business, medicine, education and more! #WomensAwards #WomenInSTEM
@hsru_aberdeen
HSRU
5 years
We are delighted to report that our @marionkcampbell is a finalist for the Services to Medicine Award at the 3rd Scottish Women's Awards 2019 to be held in Glasgow later this month. #WomensAwards #WomeninSTEM
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@MarionKCampbell
Marion Campbell
1 year
The first step in a clinical trial is deciding the #ResearchQuestion . Knowing which question is most important to focus on may not be clear cut. An interesting paper was recently published which developed a tool to rank the importance of research questions 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
One phenomenon that can affect clinical trials is the #HawthorneEffect . This is when purely being involved in a trial can improve performance. 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
10 months
This week I was reminded of the phenomenon known as #LasagnasLaw in relation to trial planning & recruitment. 1/7 #MethodologyMonday #56
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@MarionKCampbell
Marion Campbell
1 month
It is crucial for trials to be as relevant as possible to the populations they seek to inform, yet often trials lack diversity and fail to include a range of underserved groups. The #INCLUDE initiative is useful to help trials to address this 1/8 #MethodologyMonday #90
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@MarionKCampbell
Marion Campbell
3 years
Pre-island travel Covid tests ✅ Coast-to-coast drive across Scotland ✅ Loaded onto ferry ✅ #HomewardBound . First time to see my mum & family in 10 months 😊
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@MarionKCampbell
Marion Campbell
2 years
I have written about data monitoring committees (DMCs) before but this new paper from the #RECOVERY trial #DMC , which gives a fascinating insight into how complex DMC deliberations can be, makes them well worth highlighting again 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
It is important when randomising within a randomised controlled trial that there is also robust #AllocationConcealment ie that people can’t predict what the next allocation is. 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
4 years
Some reflections on the crucial role of trial data monitoring committees ( #DMCs ) at this time when we try to find out, via clinical trials, which treatments are effective for the treatment of COVID-19 1/9
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@MarionKCampbell
Marion Campbell
1 year
Ensuring #InformedConsent is a central tenet of ethical trial design. I was reminded this week of some of the recent developments in this field to help researchers with this 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
6 years
What do participants think should be in a trial information leaflet? Our new paper on this is out. Showed that patients and research nurses rank different things. We also used a novel method (Q methodology) that could have widespread applicability
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@MarionKCampbell
Marion Campbell
10 months
The topic of #StoppingRules has come up a lot in my chats this week.These are the guidelines/rules are sometimes used by data monitoring committees (DMCs) to decide whether a trial should continue or not. So what are they/how do we set them? 1/9 #MethodologyMonday #54
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@MarionKCampbell
Marion Campbell
7 months
When evaluating an intervention vs a control we often measure treatment #Fidelity - this is so we know whether the interventions were delivered as planned & whether there was a clear difference as planned between the two treatment arms 1/8 #MethodologyMonday #67
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@MarionKCampbell
Marion Campbell
3 months
Ensuring early robust evaluations of new & emerging healthcare technologies/procedures is essential to provide unbiased estimates of their true likely impact on patient care 1/7 #MethodologyMonday #82
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@MarionKCampbell
Marion Campbell
4 years
I was honoured to present the laureation address for Prof Janet Darbyshire at her honorary degree ceremony yesterday at @aberdeenuni . What an incredible career - truly inspirational! An outstanding role model for a generation of clinical trialists. Many congratulations Janet!
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@MarionKCampbell
Marion Campbell
1 year
#SCT2023 - @GilliesKatie outlines the potential contribution of behavioural science to the design & conduct of clinical trials through the #BOOST (Behaviour Optimisation & Operational Strategies for Trials) programme she leads. Key concepts here:
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@MarionKCampbell
Marion Campbell
2 months
I have spoken before about the use of routine health systems data to make clinical trials more efficient. One way of testing their potential is to undertake what has, more recently, been termed #DUCkS (Data Utility Comparison Studies) #MethodologyMonday #88 1/7
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@MarionKCampbell
Marion Campbell
5 months
#ConsensusMethods are now often being used to inform different parts of our research eg core outcome set development, priority setting etc. But what are the key points to remember? 1/7 #MethodologyMonday #72
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@MarionKCampbell
Marion Campbell
4 years
Total respect to @tomoko_ICU for a thoughtful presentation of the #VITAMINS trial at #CCR20 against some vocal criticism. Trials give unbiased evidence to help inform practice against a backdrop of variable observational data.This is important!
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@MarionKCampbell
Marion Campbell
9 months
A trial can be assessed for both #internal and #external #validity . 1/9 #MethodologyMonday #60
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@MarionKCampbell
Marion Campbell
6 years
25 years ago today I joined @hsru_aberdeen . Back then, as ever, HSRU was ahead of the curve. Trials had innovative designs: my first were a cluster switchback & a balanced incomplete block design. Oh, and a surgical RCT!! 25 years on: surgical trials & neat designs still my bag!!
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@MarionKCampbell
Marion Campbell
10 months
One of my bugbears this week - #BaselineTesting in clinical trials 1/9 #MethodologyMonday #55
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@MarionKCampbell
Marion Campbell
2 years
The #SteppedWedge trial design has cropped up multiple times in discussions with me over the last couple of weeks. It is a really neat design, often used to evaluate service-level interventions, but has some complexities that trialists should be aware of 1/6 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
4 years
When should placebo controls be used in surgical trials? When are they ethical? How should they be designed? Check the new ASPIRE guidance published in @TheLancet . Delighted to have been part of this international initiative led by @david_j_beard
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@MarionKCampbell
Marion Campbell
7 months
In the evaluation world, we often talk about the wish that healthcare providers/systems would develop into “learning health systems”. But what does a #LearningHealthSystem mean? 1/9 #MethodologyMonday #66
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@MarionKCampbell
Marion Campbell
8 months
When planning a trial there is often debate about how much one might need to inflate the sample size for to account for non-response to study patient questionnaires. But are there ways to improve #QuestionnaireResponse in the first place? 1/7 #MethodologyMonday #65
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@MarionKCampbell
Marion Campbell
2 years
Last week I talked about efficient trial design. I didn’t mention #RegistryBased trials as they are more a way to make any design more efficient... but they can lead to major efficiency gains. Some insights & learning from using them … 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
6 years
Doug was a statistical hero, a wonderful person and his impact on medical research was truly immense. He was generous, warm-hearted and fun. We have lost a giant ... Thank you for everything Doug.
@ndorms
NDORMS
6 years
It is with great sadness we share the news of Professor Doug Altman's passing. Medical research and statistics have lost one of their greatest. Thank you, Doug, for all you gave to research and the world.
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@MarionKCampbell
Marion Campbell
2 months
A paper published last week reminded me of the #FragilityIndex concept to assess the stability of the results of clinical trials 1/7 #MethodologyMonday #86
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@MarionKCampbell
Marion Campbell
1 year
Given the complexity of delivering clinical trials, they are a fertile ground to gain from #interdisciplinary thinking. For example, the field of trial #recruitment has already gained enormously from insights from other disciplinary approaches 1/7 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
3 months
We often talk about #SWATs in trials. But what are they and how/when should they be done 1/7 #MethodologyMonday #83
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@MarionKCampbell
Marion Campbell
7 months
Beautiful morning train journey back to Aberdeen after speaking on the future of technology evaluation in surgery at the excellent @EdinSurg #SchoolofSurgeryDay2023 yesterday. Fantastic research presented - the future of surgical research is bright! Thank you for inviting me.
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@MarionKCampbell
Marion Campbell
2 years
Super talk by @GilliesKatie … Behaviours are all pervasive in trials - people have to do things to make trials happen (recruit, take meds, fill questionnaires etc). We can optimise trials using a behavioural science approach. See
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@MarionKCampbell
Marion Campbell
10 months
We often hear about different forms of #Blinding in clinical trials (single/double/triple etc) but when & why is it important? 1/9 #MethodologyMonday #53
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@MarionKCampbell
Marion Campbell
4 months
Whilst interim analyses are often used in a clinical trial to check for early convincing evidence of benefit, sometimes a #FutilityAnalysis is also planned 1/9 #MethodologyMonday #79
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@MarionKCampbell
Marion Campbell
2 years
Many fields where clinical trials have traditionally focussed on purely clinical evaluations are increasingly interacting with health services/delivery research & evaluating interventions through a system lens. This adds new aspects to be considered 1/6 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
8 months
However, the ideal is to have the power of randomisation and the volume & ease of real world data work together. If we can embed randomisation more easily into routine practice, then the real world data of the future will be randomised data 😊 8/8
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@MarionKCampbell
Marion Campbell
17 days
At #CCR24 last week one method that came up was the #SlidingDichotomy method. But what is it and when might it be useful? 1/9 #MethodologyMonday #92
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@MarionKCampbell
Marion Campbell
5 months
In a clinical trial, a key step is to ensure our outcomes will measure the potential benefit of our intervention, but we must always equally focus on the collation & presentation of potential #harms 1/7 #MethodologyMonday #74
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@MarionKCampbell
Marion Campbell
4 years
A couple of reflections following a wonderful #CCR20 : 1:Trials are most successful when clinicians and methodologists work together. This maximises the potential for innovation whilst ensuring the venture is absolutely rooted in relevance to patients
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@MarionKCampbell
Marion Campbell
1 year
I was reminded this week of the impact of #attrition in clinical trials (through withdrawals;loss-to-follow-up etc) and the crucial importance of maximising trial retention 1/8 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
3 years
@NIHRresearch
NIHR Research
3 years
Today is International Day of Women and Girls in Science and we're celebrating all the fantastic women working in health and social care research. Please help us. Retweet and tag the #NIHRWomen who inspire you or an unsung hero you think deserves some extra recognition.
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@MarionKCampbell
Marion Campbell
8 years
Lots of useful, practical tips to help design trials when you have small numbers. From @mattsydes and co...
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@MarionKCampbell
Marion Campbell
1 year
When evaluating a new device or surgical procedure there is often a #LearningCurve effect to be accounted for. 1/9 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
4 years
Lots of discussion of clinical vs statistical significance at #CCR20 . The ideal is to align these from the start in the sample size calc rather than dancing the infamous “sample size samba”- fixing the sample size to an available no. of patients. Key ref:
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@MarionKCampbell
Marion Campbell
1 year
To ensure full understanding of what is being evaluated, and to ensure reproducibility, it is essential that all the elements that constitute the trial #intervention and the trial #control group are well described. 1/6 #MethodologyMonday
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@MarionKCampbell
Marion Campbell
1 year
. @GilliesKatie highlighting key work on how best to feed back trial findings to patients. Insights show that what we assume patients might want to know might not be the case! See the RECAP paper for details. #SCT2023
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