NOVEL APPLICATION OF CUSUM TECHNIQUE TO EVALUATE CHANGES IN RECRUITMENT STRATEGIES ON REFERRAL AND ENROLLMENT: IMPLICATIONS FOR PROSPECTIVE RECRUITMENT MANAGEMENT

2.50
Hdl Handle:
http://hdl.handle.net/10755/165515
Category:
Abstract
Type:
Presentation
Title:
NOVEL APPLICATION OF CUSUM TECHNIQUE TO EVALUATE CHANGES IN RECRUITMENT STRATEGIES ON REFERRAL AND ENROLLMENT: IMPLICATIONS FOR PROSPECTIVE RECRUITMENT MANAGEMENT
Author(s):
Dow, Karen; McNees, Patrick; Loerzel, Victoria
Author Details:
Karen Dow, PhD, RN, FAAN, University of Central Florida, Orlando, Florida, USA; Patrick McNees, PhD; Victoria Loerzel
Abstract:
Lagging subject enrollment in longitudinal clinical trials is a thorny problem. Little empirical evidence show the differential utility of various recruitment strategies, and few analytic and management tools exist. The CuSum (CUmulative SUMmation) technique is a simple procedure often applied in statistical process control for quality improvement and for detecting small trend shifts in highly variable serial data. The researchers describe the first reported use of CuSum in oncology nursing research, and the first innovative empirical evaluation of CuSum to the recruitment process. The purposes of this study are to: (a) determine effects of changes in referral strategies on subject enrollment in a longitudinal clinical trial using a novel application of CuSum and, (b) discuss implications of the CuSum as a tool for prospectively managing recruitment, referral, and enrollment. This work is grounded in a Quality Improvement and Statistical Process Control framework based on Shewhart and Deming. The randomized longitudinal trial tests the impact of targeted psychoeducational interventions among 250 recently diagnosed early-stage breast cancer survivors. Enrollment targets for the 4 year study projected an average of 12 referrals and 10 enrollments per month over a 25 month period. Changes in recruitment and referral strategies, with varying degrees of success, were used to achieve enrollment. A CuSum analysis was used to evaluate whether changes in recruitment influenced referral and enrollment trends. Subsequently, the data were re-analyzed applying the CuSum as if it had been employed as a prospective management tool. While monthly data were highly variable, an average of 8.42 referrals and 5.92 enrollments were realized during months 1-12. Accrual at 25 months would only have enrolled 148 subjects; 102 subjects short of target. CuSum clearly illustrated this trend. Subsequent shifts in enrollment trends were clearly shown with improvements in referral. Changes in referral trends are lead indicators of subsequent changes in enrollment. Research implications for prospective use of CuSum include (1) earlier detection of enrollment trend shifts and (2) earlier discrimination between effective and ineffective recruitment. Thus, CuSum has vital implications for both evaluation and for prospective recruitment management.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
30th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Orlando, Florida, USA
Sponsors:
Funding Sources: National Institute for Nursing Research and Office of Cancer Survivorship, National Cancer Institute
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleNOVEL APPLICATION OF CUSUM TECHNIQUE TO EVALUATE CHANGES IN RECRUITMENT STRATEGIES ON REFERRAL AND ENROLLMENT: IMPLICATIONS FOR PROSPECTIVE RECRUITMENT MANAGEMENTen_GB
dc.contributor.authorDow, Karenen_US
dc.contributor.authorMcNees, Patricken_US
dc.contributor.authorLoerzel, Victoriaen_US
dc.author.detailsKaren Dow, PhD, RN, FAAN, University of Central Florida, Orlando, Florida, USA; Patrick McNees, PhD; Victoria Loerzelen_US
dc.identifier.urihttp://hdl.handle.net/10755/165515-
dc.description.abstractLagging subject enrollment in longitudinal clinical trials is a thorny problem. Little empirical evidence show the differential utility of various recruitment strategies, and few analytic and management tools exist. The CuSum (CUmulative SUMmation) technique is a simple procedure often applied in statistical process control for quality improvement and for detecting small trend shifts in highly variable serial data. The researchers describe the first reported use of CuSum in oncology nursing research, and the first innovative empirical evaluation of CuSum to the recruitment process. The purposes of this study are to: (a) determine effects of changes in referral strategies on subject enrollment in a longitudinal clinical trial using a novel application of CuSum and, (b) discuss implications of the CuSum as a tool for prospectively managing recruitment, referral, and enrollment. This work is grounded in a Quality Improvement and Statistical Process Control framework based on Shewhart and Deming. The randomized longitudinal trial tests the impact of targeted psychoeducational interventions among 250 recently diagnosed early-stage breast cancer survivors. Enrollment targets for the 4 year study projected an average of 12 referrals and 10 enrollments per month over a 25 month period. Changes in recruitment and referral strategies, with varying degrees of success, were used to achieve enrollment. A CuSum analysis was used to evaluate whether changes in recruitment influenced referral and enrollment trends. Subsequently, the data were re-analyzed applying the CuSum as if it had been employed as a prospective management tool. While monthly data were highly variable, an average of 8.42 referrals and 5.92 enrollments were realized during months 1-12. Accrual at 25 months would only have enrolled 148 subjects; 102 subjects short of target. CuSum clearly illustrated this trend. Subsequent shifts in enrollment trends were clearly shown with improvements in referral. Changes in referral trends are lead indicators of subsequent changes in enrollment. Research implications for prospective use of CuSum include (1) earlier detection of enrollment trend shifts and (2) earlier discrimination between effective and ineffective recruitment. Thus, CuSum has vital implications for both evaluation and for prospective recruitment management.en_GB
dc.date.available2011-10-27T12:20:02Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:20:02Z-
dc.conference.date2005en_US
dc.conference.name30th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.description.sponsorshipFunding Sources: National Institute for Nursing Research and Office of Cancer Survivorship, National Cancer Institute-
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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