What tastes better, normal or sugar free lemonade?: Findings from the Great Exhibition Road Festival
Earlier this year, on the 18th and 19th June 2022 Imperial College held its free annual Great Exhibition Road Festival. The festival is an opportunity for staff at the university to showcase their research and engage with the public. The event is also a collaboration with other institutes around Great Exhibition Road such as the Science Museum and the Royal College of Arts
allowing a rich diversity of stalls from science to the arts.
Imperial Clinical Trials Unit Involvement
This year the Imperial Clinical Trials Unit (ICTU) had our own stall with the concept being driven by Jack Elkes and Ellie Van Vogt who both work in the statistics team in the unit. The stall was manned on the days by a wide range of our colleagues at ICTU who each could offer a unique perspective of working on clinical trials. Our theme was called Trial Blazers, and the aim was to provide the public with an introduction to clinical trials by having them run their own study or take part in a live trial running throughout the festival.
Our first activity was an interactive version of the James Lind trial (the first recorded clinical trial), where attendees could randomise several sailors with different characteristics to scurvy treatments: oranges, or chocolate. Once allocated we would reveal the outcome of the trial; how many sailors were ill on each of the treatment boats. They were then invited to talk about why there are differences in outcomes of the two treatments boats. The key message was that randomisation means we know which of the treatments was causing the sickness by balancing any other potential bias. This is because the only difference between the sailors on each treatment boat was the treatment they were given. Participants were also offered their own treatment for taking part: a sherbet lemon (to represent an orange) or a chocolate coin!
We also had a mini real-life randomised clinical trial set up. We were investigating if people were able to distinguish between normal and sugar free lemonade and which lemonade was rated better for taste. We explained our trial to the participants who came to our stall and then would ask them for verbal informed consent, explaining how this would be taken in a real trial. We then collected some characteristics from the trial participants such as their favourite colour and if they are left or right-handed. The trial participants were then randomised by simple randomisation by the method of a coin toss. They were invited to blindly sample the lemonade they were randomised to. Once they had tasted this, they were asked to rank the taste of their lemonade on a ten-point scale (10 being tastiest!) as well as guess the lemonade they believed they had sampled. The method of the randomisation meant that the only difference between the groups would be the lemonade that they tried. This means we can make a fair comparison of the results and attribute any differences between the groups ranking of the lemonade to the lemonade that they tasted.
Their data was collected in our physical data base, a cardboard box for the purpose of the trial, which was to represent the clinical trial database. The data was then uploaded and analysed by the statisticians. We published the results live on our screen as well as sharing the final results of the trial on our twitter page @stats_ci and in this blog post.
Summary of Results
Overall, we had 236 participants enrolled into the trial across the weekend. The two treatment groups were of a similar size; 117 participants in the lemonade arm and 119 in the sugar-free lemonade arm. The characteristics collected from the participants through the trial were also balanced between the two groups and can seen in the table below (Table 1). This shows us that the randomisation to the two treatment arms was successful as the two treatment groups were similar at baseline which minimises bias.
The trial found that the taste of the two lemonades ranked similarly; both had a median score of 8 (Figure 1). There is some skew in both arms and the participants in the sugar-free lemonade arm showed a wider dispersion of results (Figure 1).
Participants randomised to the normal lemonade correctly identified which lemonade they consumed more frequently (green portion of the bar chart) than those in the sugar-free lemonade arm (Figure 2).
Reflections on the day: Annie, Statistician at ICTU
I wasn’t sure what to expect from the day having not attended the festival before and I had recently joined the ICTU team, but I was keen to get the public involved in research. It is important for people to know more about clinical trials and how they are run as this may prevent hesitancy to take part in one should they be eligible in the future. I expected the audience to be mainly younger children naively! However, we had such a wide range of people come up to our stand to take part in both activities. It was interesting to tailor the experience of the activities on the spot to the audience and how conversations regarding the trial opened up. I was able to speak to primary school aged children, current university students and staff, as well as staff alumni who had come along for the weekend. It was a really rewarding experience and I hope it will encourage people to get involved with trials in the future whether that be taking part in one or working in the area.
The Great Exhibition Road Festival will be taking place again in on the 17th and 18th of June 2023! A full programme will be released in Spring 2023 but you can check out the previous programme for some inspiration. We hope to see you all there next year!
Thanks again to Jack Elkes and Ellie Van Vogt for designing the concept of the stall, Leila Janani and Jack Elkes for the preparation of materials, Meena’s husband for the illustrations for the James Lind Trial activity, colleagues at ICTU for their input on the design, Lauren Noto for organising the funding to buy the equipment and Ana Boshoff, Amanda Bravery, Gavin Bravery, Claire Brennan, Suzie Cro, Francesco Lala, Daphne Babalis, Lee Webber, Meena Reddi, Annie Wright, Jack Elkes, Leila Janani, Ellie Van Vogt and Aisha Anjum for volunteering on the day.