Treatment preference and recruitment to pediatric RCTs: A systematic review

Lucy Beasant*, Amberly Brigden, Roxanne Parslow, Harry Apperley, Tiffany Keep , Antonia Northam, Charlotte Wray, Hayley King, Ryan Langdon, Nicola Mills, Bridget Young, Esther Crawley

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
237 Downloads (Pure)


Background: Recruitment to pediatric randomised controlled trials (RCTs) can be a challenge, with ethical issues surrounding assent and consent. Pediatric RCTs frequently recruit from a smaller pool of patients making adequate recruitment difficult. One factor which influences recruitment and retention in pediatric trials is patient and parent preferences for treatment. Purpose: To systematically review pediatric RCTs reporting treatment preference. Methods: Database searches included: MEDLINE, CINAHL, EMBASE, and COCHRANE. Qualitative or quantitative papers were eligible if they reported: pediatric population, (0–17 years) recruited to an RCT and reported treatment preference for all or some of the participants/parents in any clinical area. Data extraction included: Number of eligible participants consenting to randomisation arms, number of eligible patients not randomised because of treatment preference, and any further information reported on preferences (e.g., if parent preference was different from child). Results: Fifty-two studies were included. The number of eligible families declining participation in an RCT because of preference for treatment varied widely (between 2 and 70%) in feasibility, conventional and preference trial designs. Some families consented to trial involvement despite having preferences for a specific treatment. Data relating to ‘participant flow and recruitment’ was not always reported consistently, therefore numbers who were lost to follow-up or withdrew due to preference could not be extracted. Conclusions: Families often have treatment preferences which may affect trial recruitment. Whilst children appear to hold treatment preferences, this is rarely reported. Further investigation is needed to understand the reasons for preference and the impact preference has on RCT recruitment, retention and outcome.

Original languageEnglish
Article number100335
Number of pages11
JournalContemporary Clinical Trials Communications
Early online date19 Feb 2019
Publication statusPublished - 1 Jun 2019

Structured keywords

  • Centre for Surgical Research


  • Parent
  • Pediatric
  • Randomised controlled trial
  • Recruitment
  • Treatment preference


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