Randomised studies abroad can be challenging
CIMT researcher Knud Yderstræde has been opponent on a PhD study from Ethiopia, where the effect of a nurse-based intervention on the regulation of glucose and on empowerment was evaluated.
The study illustrated how difficult it can be to conduct randomised trials in developing countries; in the specific study, the rainy season affected, for example, attendance, and participants shared their knowledge on buses, at the outpatient clinic and in the villages - so-called "information spill-over". During the process, the area was further ravaged by war and corruption, so that a number of participants were transferred to other hospitals or lost to follow-up.
Knud Yderstræde says: "In developing countries, it is very difficult to conduct randomised studies without disturbing external influences, and this study thus also took six years to complete". Therefore, he emphasises that a study design must be thoroughly thought out before a study is started. Drop-out, disruptions and whether it is possible to reach enough people included are essential elements in the planning of studies in countries south of the Sahara. Studies of this kind will have more of the character of pragmatic studies, because randomisation can be difficult due to the aforementioned peer-to-peer information and information spill-over.