Application of Innovative Subject Recruitment System for Batch Enrollment: A Pilot Study.

INTRODUCTION: Using a digital process that leverages electronic health records (EHRs) can ease many of the challenges presented by the traditional enrollment process for clinical trials. We tested if automated batch enrollment using a technology-enabled subject recruitment system (TESRS) enhances recruitment while preserving representation of research subjects for the study population in our study setting. METHODS: An ongoing community-based prospective adult cohort study was used to randomize 600 subjects who were eligible by age and residential address to TESRS (n = 300) and standard mailing method (n = 300), respectively, for 3 months. Then, TESRS was initiated and included automatic identification of patients' preference for being contacted (online patient portal vs postal mail) from EHRs and automatic sending out of invitation letters followed by completion of a short online survey for checking eligibility and the digital consent process if eligible. We compared (1) median time to consent from invitation sent out per subject and total subjects recruited after a 3-month recruitment period, (2) the estimated study staff's time, and (3) representation of sociodemographic characteristics (e.g., age, sex, race, SES measured by HOUSES index, and rural residence) between subjects recruited via TESRS and those via traditional mailing methods. RESULTS: Median age of randomized subjects (n = 600) was 63 years with 52.0% female and 89.2% non-Hispanic White. Over a 3-month period, results showed consent rate via TESRS was 13% (39/297) similar to 11% (31/295) via standard mailing. However, recruitment was significantly faster with the TESRS approach (median 7 vs 26 days) given the study staff's effort. Study staff's time saved by using TESRS compared to standard mailing approach was estimated at 40 min per subject (equivalent to 200 h for 300 subjects). No significant differences in characteristics of research subjects from the study population were found. CONCLUSION: Our study demonstrated the utility of TESRS as a subject recruitment digital technology which significantly enhanced the recruitment effort while reducing the study staff burden of recruitment while maintaining the consistency of characteristics of recruited subjects. The strategy and support for implementing and testing TESRS in other study settings should be considered.

Circadian response of annual weeds in a natural setting to high and low application rates of four herbicides with different modes of actions.

Four herbicides [glyphosate (GLYT), an amino acid synthesis inhibitor; glufosinate (GLUF), a glutamine synthetase inhibitor; fomesafen (FOME), a protoporphyrinogen oxidase inhibitor, and chlorimuron ethyl (CLIM), an acetolactate synthase inhibitor] were used to examine the influence of time of day of application on the control of a variety of annual broadleaf weeds in field studies conducted in Minnesota (five studies on GLYT and GLUF, three studies on FOME and CLIM). All herbicides were applied with an adjuvant at recommended high and low (half or quarter strength) rates every 3h between 06:00 and 24:00h local time. Visual ratings of percent weed control evaluated at 14d were analyzed by herbicide and application rate for each study and across studies for time-of-day effect by analysis of variance (ANOVA) and single cosinor. A circadian response to each herbicide was found, with greatest weed control observed between 09:00 and 18:00h. Increasing the herbicide application rate did not overcome the time-of-day effect (ANOVA: p < or = 0.008 for time-of-day effect for each herbicide and application rate). The least-squares fit of a 24h cosine was significant (p < or = 0.001) for each herbicide and application rate, with double amplitudes of 18-82% (units = % visual control) and estimated peaks (acrophases) near midday between 12:40 and 13:35h. Analysis of residuals obtained from multiple regression that included weed height, herbicide rate, temperature, and relative humidity as independent factors also found a significant time-effect by both ANOVA and cosinor for each herbicide and rate, with acrophases advancing significantly by 3 to 7h for GLYT and GLUF, but not for FOME or CLIM. These results suggest that the four herbicides, while belonging to different families with different modes of action, may reveal different peak times of efficacy when adjusting for environmental factors. Nonetheless, each displays similar circadian patterns when influenced by these factors under natural seasonal field conditions. The within-day rhythmic differences found in weed control are large enough to warrant consideration of the practical financial and environmental importance of the time-of-day that these and other herbicides are applied.