Table 1.

Some [but probably not all] difficulties instigating and recruiting people to randomized trials

Difficulties in central priority setting
Can be driven by political ethos and time scales
Limited skill prioritizing answerable questions of importance to everyone concerned
Difficulties presented by the funding decision-making process
May be	made without knowledge of innovations in methodology in other specialties
	Unimaginative
	Risk-averse
	Self-serving
	Biased
Difficulties at the level of research regulation and governance
Integrated Research Application System*(IRAS)
Research Ethics Committee*
Local Scientific Committees
Difficulties to do with health care organization partnerships
e.g. NHS support costs*
Difficulties to do with data acquisition
Quality*
Access*
Difficulties to do with carers
Clinical staff*
Attitudes*
Time constraints*
Families/other lay carers
Difficulties to do with patients
Illness-specific Attitude
Difficulties to do with research design
Explanatory v. pragmatic
Participants
Interventions
Outcomes
Consent practices disempowering participants
Less than transparent research practice
Difficulties in trial management
Staff issues
Trail unit ethos

*Mentioned in Leeson & Tyrer (2013).