#RCTDebate – what did we learn?
by Vanessa Pinfold
Our first ever public event was held on 8th October 2015 at the Jerwood Space. This was a chance to bring people with different expertise together to consider the role of the RCT (Randomised Control Trial) in mental health research design. It was also the launch of our Talking Point series of papers – a group of papers written by survivor / service user researchers on under discussed topics. Our launched paper by Alison Faulkner has a title that speaks for itself: “RCTs: the straitjacket of mental health research?
We are going to be following up points that came up in our discussion in the coming weeks. What was very clear from all who attended is this is a very important issue – not just for mental health but across the health sector. We need better quality studies and we need to talk about how to improve our methodologies.
One point raised was the place of the RCT in the hierarchy of evidence. One audience member commented how we need not to reduce the importance of the RCT but raise the weight of other approaches. What might they be? The use of routine data on population level data bases was one suggestion, particularly if data quality can be improved and bias controlled. Alison spoke about survivor research methods.
Outcome selection in RCTs is crucial – and how this happens. At the event there was lively discussion. Some felt too many trials are looking for clinical outcomes, with a strong suggestion that a co-production selection process should be encouraged. I am involved in a study where consensus methods have been used in the last month to select the primary outcome measure balancing service user and carer, practitioner and researcher expertise. The decision was quality of life which all believed was an important goal – consensus was reached. But, will the intervention we have designed shift quality of life? Time will tell.
Improving the quality of trial science was strongly advocated. We were told charities have a role in pushing forward standards and working tirelessly to ensure they are delivered. Charities do this in other health areas – where is the public and patient voice in the mental health research community on this issue? I reflect that this is best done in partnership – maybe the Alliance of mental health research charities that I chair can help.
We did try to extend the debate onto social media. Mental Elf attended and they will be posting a blog on Alison’s paper. We look forward to reading that and continuing #RCTDebate
Vanessa Pinfold, Research Director McPin Foundation