Welcome to the TwiCs network where we share information about the Trials within Cohorts (TwiCs) system for designing and conducting practical randomised controlled trials.
Forthcoming events
Introduction to TwiCs within hospitals and other settings
One day course
Queen Mary University London
23rd April 2020
Linking long-term longitudinal studies and RCTs
Talk at the Royal Statistical Society, London
27th March 2020
HOT PRESS
"Ethics and practice of Trials within Cohorts"
"Just in time consent: the ethical case for an alternative to traditional informed consent"
First approved CTIMP using TwiCs design - ASSESS - meso led
Anna Bibby at Bristol University.
CONSORT REPORTING GUIDELINES due 2020
Extension to Improve Reporting of Trials Using Observational Cohorts, Registries and Routinely Collected Health Data
(Funded by the Canadian Institutes of Health Research and the UK NIHR Clinical Trials Unit Support Funding)
The design (Trials within Cohorts)
Trials within Cohorts (TwiCs): an approach to trial design which uses infrastructures (cohorts) to facilitate multiple randomised controlled trials
The term 'TwiCs' was created for the first symposium on the 'cohort multiple RCT' design. This approach to trial design (the cmRCT design) was first described in the BMJ in 2010 article in the context of healthcare. Key features of the cmRCT design are:
(I) A large observational cohort of people with the condition
(II) Regular measurement of outcomes for the whole cohort
(III) Capacity for multiple randomised controlled trials over time
The advantages of the design are that the cohort serves as a representative
pool from which eligible people can be selected and approached for trial
participation and a platform in which multiple interventions
can be tested simultaneously (efficient use of control patients, improved
comparison between different interventions) and contamination between
study arms is minimised. As the design uses patient-centred informed
consent procedure this is expected to lead to higher, more representative
recruitment.
More than 70 studies have or are using the design. Researchers in
the UK, Canada, USA, France, Netherlands, Finland, and Australia; are use
the TwiCs design approach to help address questions in a variety of fields
(breast cancer, bone metastases, rectal cancer, mental health, care of the elderly,
rare diseases, etc). The design is now being used to trial both
medicinal products (CTIMPs) and non-medicinal products.
Though originating in healthcare, the TwiCs approach to trial design can be used to inform decision making in any area, e.g. education, social care, crime, energy use.
This website describes key features of the TwiCs approach and links to articles describing the methodologies, and examples of use of the TwiCs
approach in hospital settings and primary care/ population based settings.
