Independent but coordinated trials: insights from the practice-based Opportunities for Weight Reduction Trials Collaborative Research Group.
BACKGROUND
The National Heart, Lung, and Blood Institute (NHLBI) funded three institutions to conduct effectiveness trials of weight loss interventions in primary care settings. Unlike traditional multi-center clinical trials, each study was established as an independent trial with a distinct protocol. Still, efforts were made to coordinate and standardize several aspects of the trials. The three trials formed a collaborative group, the 'Practice-based Opportunities for Weight Reduction (POWER) Trials Collaborative Research Group.'


OBJECTIVE
We describe the common and distinct features of the three trials, the key characteristics of the collaborative group, and the lessons learned from this novel organizational approach.


METHODS
The Collaborative Research Group consists of three individual studies: 'Be Fit, Be Well' (Washington University in St. Louis/Harvard University), 'POWER Hopkins' (Johns Hopkins), and 'POWER-UP' (University of Pennsylvania). There are a total of 15 participating clinics with ~1100 participants. The common primary outcome is change in weight at 24 months of follow-up, but each protocol has trial-specific elements including different interventions and different secondary outcomes. A Resource Coordinating Unit at Johns Hopkins provides administrative support.


RESULTS
The Collaborative Research Group established common components to facilitate potential cross-site comparisons. The main advantage of this approach is to develop and evaluate several interventions, when there is insufficient evidence to test one or two approaches, as would be done in a traditional multi-center trial.


CONCLUSIONS
The challenges of the organizational design include the complex decision-making process, the extent of potential data pooling, time intensive efforts to standardize reports, and the additional responsibilities of the DSMB to monitor three distinct protocols.
Yeh
Hsin-Chieh
HC
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. hyeh1@jhmi.edu
Clark
Jeanne M
JM
Emmons
Karen E
KE
Moore
Reneé H
RH
Bennett
Gary G
GG
Warner
Erica T
ET
Sarwer
David B
DB
Jerome
Gerald J
GJ
Miller
Edgar R
ER
Volger
Sheri
S
Louis
Thomas A
TA
Wells
Barbara
B
Wadden
Thomas A
TA
Colditz
Graham A
GA
Appel
Lawrence J
LJ
D002985:Clinical Protocols; D002986:Clinical Trials as Topic / Q000379:methods*; D006801:Humans; D015337:Multicenter Studies as Topic / Q000379:methods*; D011320:Primary Health Care; D012107:Research Design; D015431:Weight Loss