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Recruitment to diagnosis of urinary tract infections in young children (DUTY) study: an evaluation of the successful methods used in a primary care, prospective cohort study

Introduction and aims

DUTY is a prospective cohort study to derive a clinical algorithm for diagnosis of urinary tract infections in acutely unwell children in primary care.

It provides an example of successful recruitment to a complex paediatric study, requiring the collection of a urine sample from young, unwell children. The aim is to describe and evaluate factors that contributed to its success from a study management and recruiter perspective.


Four centres (Bristol, Cardiff, Southampton, London) coordinated recruitment from primary care sites across England and Wales. Two recruitment methods were available: 'Option 1' where research nurses supported, and 'Option 2' involving autonomous recruitment by NHS primary care team.

An evaluation of these methods and analysis of feedback questionnaires given to recruiting sites and research nurses involved in DUTY will be made.


Out of 233 sites, 43% employed option 1 recruitment. 7163 children were recruited and 6390 (89%) urine samples were retrieved. (Bristol=2947 recruits, 92% retrieval rate, Cardiff=1768, 89%, London=1435, 84% and Southampton=1013, 90%).

Further analysis regarding option 1 and option 2 recruitment methods and feedback from recruiting sites and research nurses will be available for presentation in November 2013.


The success of DUTY to recruit above target is attributed to continuous availability of peer-support, adequate service support reimbursement, real-time data monitoring through web-based data entry, and the flexible offer of two recruitment methods. Feedback from recruiting sites and research nurses provides valuable insight into how recruitment in primary care can be optimised and improved in the future.

Author information

Correspondence to Cherry-Ann Waldron.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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About this article


  • Primary Care
  • Urinary Tract Infection
  • Urine Sample
  • Prospective Cohort Study
  • Research Nurse


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