Recruiting Control Participants into Stroke Biomarker Studies

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REVIEW ARTICLE

Recruiting Control Participants into Stroke Biomarker Studies Matthew A. Edwardson 1

&

Stephen J. Fernandez 2

Received: 24 September 2019 / Revised: 25 November 2019 / Accepted: 2 January 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract The number of scientists using –omics technologies to investigate biomarkers with the potential to gauge risk and aid in the diagnosis, treatment, and prognosis of stroke continues to rise, yet there are few resources to aid investigators in recruiting control participants. In this review, we describe two major strategies to match control participants to a stroke cohort-propensity score matching and one-to-one matching—including statistical approaches to gauge the balance between groups. We then explore the advantages and disadvantages of traditional recruitment methods including approaching spouses of enrolled stroke participants, direct recruitment from clinics, community outreach events, approaching retirement communities, and buying samples from a 3rd party vendor. Newer methods to identify controls by screening the electronic health record and using an online screening questionnaire are also described. Finally, we cover compensation for control participants and special considerations. The hope is that this review will serve as a roadmap whereby an investigator can successfully tailor their control recruitment strategy to the research question at hand and the local research environment. While this review is focused on blood-based biomarker studies, the principles will apply to investigators studying a broad range of biological materials. Keywords Biomarkers . Stroke . Matched groups . Research subject recruitment . Propensity scores . Electronic health record

Introduction Biomarkers are biological signatures used to indicate the presence of some other biological phenomenon in health and disease. In the context of stroke, biomarkers are useful both clinically and in research to gauge stroke risk [1] and aid in diagnosis [2, 3], prognosis [4], and directing treatment decisions [5]. Some examples of widely used clinical biomarkers include blood low density lipoprotein (LDL) level as a risk factor for stroke [6], diffusion-weighted MRI to diagnose ischemic stroke [7], and the degree of stenosis on carotid imaging to guide treatment decisions for carotid atherosclerotic disease [8, 9]. There are also many stroke biomarkers under evaluation in research such as plasma NT-proBNP, a Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12975-020-00780-6) contains supplementary material, which is available to authorized users. * Matthew A. Edwardson [email protected] 1

Department of Neurology, Georgetown University, 4000 Reservoir Rd. NW, Building D Room 207, Washington, DC, USA

2

MedStar Health Research Institute, Washington, DC, USA

biomarker of cardiac myocyte dysfunction linked to an increased risk of ischemic stroke [1]. NT-proBNP is currently under a study to help direct the decisi