An investigation of the shortcomings of the CONSORT 2010 statement for the reporting of group sequential randomised controlled trials: a methodological systematic review

Background It can be argued that adaptive designs are underused in clinical research. We have explored concerns related to inadequate reporting of such trials, which may influence their uptake. Through a careful examination of the literature, we evaluated the standards of reporting of group sequential (GS) randomised controlled trials, one form of a confirmatory adaptive design. Methods We undertook a systematic review, by searching Ovid MEDLINE from the 1st January 2001 to 23rd September 2014, supplemented with trials from an audit study. We included parallel group, confirmatory, GS trials that were prospectively designed using a Frequentist approach. Eligible trials were examined for compliance in their reporting against the CONSORT 2010 checklist. In addition, as part of our evaluation, we developed a supplementary checklist to explicitly capture group sequential specific reporting aspects, and investigated how these are currently being reported. Results Of the 284 screened trials, 68(24%) were eligible. Most trials were published in “high impact” peer-reviewed journals. Examination of trials established that 46(68%) were stopped early, predominantly either for futility or efficacy. Suboptimal reporting compliance was found in general items relating to: access to full trials protocols; methods to generate randomisation list(s); details of randomisation concealment, and its implementation. Benchmarking against the supplementary checklist, GS aspects were largely inadequately reported. Only 3(7%) trials which stopped early reported use of statistical bias correction. Moreover, 52(76%) trials failed to disclose methods used to minimise the risk of operational bias, due to the knowledge or leakage of interim results. Occurrence of changes to trial methods and outcomes could not be determined in most trials, due to inaccessible protocols and amendments. Discussion and Conclusions There are issues with the reporting of GS trials, particularly those specific to the conduct of interim analyses. Suboptimal reporting of bias correction methods could potentially imply most GS trials stopping early are giving biased results of treatment effects. As a result, research consumers may question credibility of findings to change practice when trials are stopped early. These issues could be alleviated through a CONSORT extension. Assurance of scientific rigour through transparent adequate reporting is paramount to the credibility of findings from adaptive trials. Our systematic literature search was restricted to one database due to resource constraints.

Holocene tidal palaeochannels, Severn Estuary Levels, UK: a search for granulometric and foraminiferal criteria

Holocene tidal palaoechannels, Severn Estuary Levels, UK: a search for granulometric and foraminiferal criteria. Proceedings of the Geologists' Association, 117, 329-344. Grain-size characteristics (by laser granulometry) and foraminiferal assemblages have been established for silts accumulated in five, dissimilar tidal palaeochannels of mid or late Holocene age in the Severn Estuary Levels, representative of muddy tidal systems. For purposes of general comparison, similar data were obtained from a representative active tidal inlet in the area, but all of these channels have been subject to human interference and are not relied upon as a model for environmental interpretation. Although the palaeochannel deposits differ substantially in their bedding characteristics and stratigraphical relationships from the level-bedded salt-marsh platform and mudflat deposits with which they are associated, and although the channel environment is distinctive morphologically and hydraulically, no critical textural differences could be found between the channel deposits and the associated facies. Similarly, no foraminiferal assemblages distinctive of a tidal channel were encountered. Instead, the assemblages compare with those from mudflats and salt-marsh platforms. It is concluded that the sides of the subfossil channels carried some vegetation, as was observed to be the case in the modern inlet. An alternative approach is necessary if concealed palaeochannel deposits are to be recognized in muddy systems from limited numbers of subsurface samples. Although the palaeochannels afforded no characteristic textural signature, they yield transverse grain-size patterns pointing to coastal movements during their evolution. Concave-up trends suggest outward coastal building, whereas convex-up ones point to marsh-edge retreat.

Enhanced phytoextraction: In search of EDTA alternatives

Enhanced phytoextraction proposes the use of soil amendments to increase the heavy-metal content of above-ground harvestable plant tissues. This study compares the effect of synthetic aminopolycarboxylic acids [ethylenediamine tetraacetatic acid (EDTA), nitriloacetic acid (NTA), and diethylenetriamine pentaacetic acid (DTPA)] with a number of biodegradable, low-molecular weight, organic acids (citric acid, ascorbic acid, oxalic acid, salicylic acid, and NH4 acetate) as potential soil amendments for enhancing phytoextraction of heavy metals (Cu, Zn, Cd, Pb, and Ni) by Zea mays. The treatments in this study were applied at a dose of 2 mmol/kg(-1) 1 d before sowing. To compare possible effects between presow and postgermination treatments, a second smaller experiment was conducted in which EDTA, citric acid, and NH4 acetate were added 10 d after germination as opposed to 1 d before sowing. The soil used in this screening was a moderately contaminated topsoil derived from a dredged sediment disposal site. This site has been in an oxidized state for more than 8 years before being used in this research. The high carbonate, high organic matter, and high clay content characteristic to this type of sediment are thought to suppress heavy-metal phytoavailability. Both EDTA and DTPA resulted in increased levels of heavy metals in the above-ground biomass. However, the observed increases in uptake were not as large as reported in the literature. Neither the NTA nor organic acid treatments had any significant effect on uptake when applied prior to sowing. This was attributed to the rapid mineralization of these substances and the relatively low doses applied. The generally low extraction observed in this experiment restricts the use of phytoextraction as an effective remediation alternative under the current conditions, with regard to amendments used, applied dose (2 mmol/kg(-1) soil), application time (presow), plant species (Zea mays), and sediment (calcareous clayey soil) under study.

Decentralized load balancing for highly irregular search problems

In this paper, we present a distributed computing framework for problems characterized by a highly irregular search tree, whereby no reliable workload prediction is available. The framework is based on a peer-to-peer computing environment and dynamic load balancing. The system allows for dynamic resource aggregation, does not depend on any specific meta-computing middleware and is suitable for large-scale, multi-domain, heterogeneous environments, such as computational Grids. Dynamic load balancing policies based on global statistics are known to provide optimal load balancing performance, while randomized techniques provide high scalability. The proposed method combines both advantages and adopts distributed job-pools and a randomized polling technique. The framework has been successfully adopted in a parallel search algorithm for subgraph mining and evaluated on a molecular compounds dataset. The parallel application has shown good calability and close-to linear speedup in a distributed network of workstations.

In search of simple structures in climate: Simplifying EOFs

Empirical orthogonal functions (EOFs) are widely used in climate research to identify dominant patterns of variability and to reduce the dimensionality of climate data. EOFs, however, can be difficult to interpret. Rotated empirical orthogonal functions (REOFs) have been proposed as more physical entities with simpler patterns than EOFs. This study presents a new approach for finding climate patterns with simple structures that overcomes the problems encountered with rotation. The method achieves simplicity of the patterns by using the main properties of EOFs and REOFs simultaneously. Orthogonal patterns that maximise variance subject to a constraint that induces a form of simplicity are found. The simplified empirical orthogonal function (SEOF) patterns, being more 'local'. are constrained to have zero loadings outside the main centre of action. The method is applied to winter Northern Hemisphere (NH) monthly mean sea level pressure (SLP) reanalyses over the period 1948-2000. The 'simplified' leading patterns of variability are identified and compared to the leading patterns obtained from EOFs and REOFs. Copyright (C) 2005 Royal Meteorological Society.

A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service

Objective: To evaluate CBTp delivered by non-expert therapists, using CBT relevant measures. Methods: Participants (N=74) were randomised into immediate therapy or waiting list control groups. The therapy group was offered six months of therapy and followed up three months later. The waiting list group received therapy after waiting nine months (becoming the delayed therapy group). Results: Depression improved in the combined therapy group at both the end of therapy and follow-up. Other significant effects were found in only one of the two therapy groups (positive symptoms; cognitive flexibility; uncontrollability of thoughts) or one of the two timepoints (end of therapy: PANSS general symptoms, anxiety, suicidal ideation, social functioning, resistance to voices; follow-up: power beliefs about voices, negative symptoms). There was no difference in costs between the groups. Conclusions: The only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.