A new paradigm for conducting efficient, online, co-produced eczema trials – the Rapid Eczema Trials project
Problem
Clinical trials are the best way of comparing different treatments, but they can be time consuming, expensive, and do not always answer questions that are important to patients. The Rapid Eczema Trials project provides an innovative way of delivering sustainable, patient-centred clinical trials.This project combines the benefits of citizen science and co-production with efficient clinical trial design to deliver multiple online trials about how to improve self-management of eczema.
Approach
We have established an Eczema Citizen Science Community of people interested in co-producing online clinical trials to answer questions about the self-management of eczema (www.RapidEczemaTrials.org). Working with researchers and clinicians, this community of citizen scientists are prioritising research questions and designing trials to address questions of importance to people living with eczema. They are also promoting the project amongst their wider networks and will help analyse qualitative data from the process evaluation of the project.This 5-year project will deliver multiple eczema trials. All trials will be conducted according to a master protocol, database, and analysis plan to ensure efficiency whilst maintaining quality standards.
Findings
The Rapid Eczema Trials project started in Sept 2022. We currently have 359 members who have signed up to receive monthly newsletter updates. Three topics for online clinical trials have been prioritised: 1) Best way to bathe when you have eczema; 2) Best ways to keep control of eczema between flare-ups; and 3) Psychological interventions for people with eczema.Trials are being co-produced by the Eczema Citizen Science Community in partnership with healthcare professionals and researchers. Decisions are informed by targeted surveys amongst the wider Eczema Citizen Science Community to ensure inclusivity by design.All trials are delivered online – bringing research to people with eczema without geographical or socio-economic barriers. We are also exploring the feasibility of using machine learning to evaluate eczema severity based on digital photos, to supplement participant reported outcomes.Our first trial will answer the question: "Is it better to bathe daily or weekly when you have eczema?”; a commonly asked question in clinical practice that has not been addressed by research. The trial is recruiting 390 people with eczema of all ages and all eczema severities. Primary outcome is patient reported eczema symptoms (Patient Reported Eczema Measure, POEM) assessed weekly for 4 weeks. Recruitment is via the Eczema Citizen Science Community, social media advertising and through mailout from GP surgeries.
Consequences
This innovative programme will deliver multiple, high-quality randomised controlled trials that address topics that are important to people with eczema. By sharing our protocols, database and analysis plans, we hope to encourage others to design rapid and efficient trials in other healthcare settings.