Efficiency by design: remoulding randomised evaluations in improvement studies

Richard carried out research into innovative design of randomised control trials such as the stepped wedge. A stepped wedge trial is a type of randomised trial which takes place over an extended interval of time and allows for clusters of participants to cross over from routine care to an experimental intervention over the course of a trial. This may seem quite technical but is important to find out which new and complex treatments are effective. This type of trial has become popular in recent years, and Richard looked at ways of both improving efficiencies and easing the burden on participants.

Over the course of his fellowship, he has published several papers discussing different aspects of stepped wedge trials, including a paper on the subject of optimal design of cluster randomised trials, and he gave a keynote talk at the THIS Space conference in November 2021, entitled ‘The shape of trials’ which you can watch here.

In his talk, Richard discusses the value of incremental change, along with the need to use innovative trial methods to help reduce the burden for participants, minimise costs of recruitment and assessment, and help with recruiting participants across different sites, to maximise the quality of any studies undertaken.

Richard designed and developed a highly informative blog, Stepped wedgehog, which is an excellent resource for those interested in the stepped wedge trials. The blog details the history, background, and ethics of this type of trial, and provides links to useful information sources.