title: Strategies to Maximize Enrollment in a Prospective Study of Comatose Children in the PICU.
abstract: OBJECTIVE
  To analyze barriers to recruitment encountered during a prospective study in the PICU and evaluate strategies implemented to improve recruitment.
  
  
  METHODS
  Prospective observational study of continuous electroencephalogram monitoring in comatose children.
  
  
  METHODS
  PICUs at four North American institutions.
  
  
  METHODS
  Patients with a Glasgow Coma Scale score of less than or equal to 8 for at least an hour.
  
  
  METHODS
  Four strategies to increase recruitment were sequentially implemented.
  
  
  RESULTS
  The baseline enrollment rate was 2.1 subjects/mo, which increased following the single-site introduction of real-time patient screening using an online dashboard (4.5 subjects/mo), deferred consenting (5.2 subjects/mo), and weekend screening (6.1 subjects/mo). However, the subsequent addition of three new study sites was the greatest accelerator of enrollment (21 subjects/mo), representing a 10-fold increase from baseline (p < 0.0001).
  
  
  CONCLUSIONS
  Identifying barriers to recruitment and implementing creative strategies to increase recruitment can successfully increase enrollment rates in the challenging ICU environment.
authors.affiliation: 1Division of Neurology, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada. 2Department of Critical Care Medicine, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada. 3Division of Pediatric Neurology, Department of Neurology, Mayo Clinic, Rochester, MN. 4Departments of Neurology and Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. 5Division of Neurology, Department of Pediatrics, Duke Children's Hospital and Duke University School of Medicine, Durham, NC. 6Department of Neurology, University of California San Francisco, San Francisco, CA.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: McBain
authors.forename: Eric T
authors.initials: ET
authors.lastname: Payne
authors.forename: Rohit
authors.initials: R
authors.lastname: Sharma
authors.forename: Helena
authors.initials: H
authors.lastname: Frndova
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Abend
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Sánchez
authors.forename: William B
authors.initials: WB
authors.lastname: Gallentine
authors.forename: Karen M
authors.initials: KM
authors.lastname: Cornett
authors.forename: Kendall B
authors.initials: KB
authors.lastname: Nash
authors.forename: O Carter
authors.initials: OC
authors.lastname: Snead
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parshuram
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Hutchison
authors.forename: Cecil D
authors.initials: CD
authors.lastname: Hahn
mesh_terms: D002648:Child; D003128:Coma; D004569:Electroencephalography; D015600:Glasgow Coma Scale; D006801:Humans; D015278:Intensive Care Units, Pediatric; D064887:Observational Studies as Topic; D018579:Patient Selection; D011446:Prospective Studies
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