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Testing crossover studies for carryover effects.

T J Cleophas1

  • 1Department of Medicine, Merwede Hospital Sliedrecht Dordrecht, Sliedrecht, The Netherlands.

Angiology
|April 1, 1989
PubMed
Summary

Crossover studies are preferred for cardiovascular diseases, but few papers test for carryover effects. This analysis reveals a gap between statistical recommendations and published research practices in cardiology journals.

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Area of Science:

  • Cardiology
  • Clinical Trials
  • Biostatistics

Background:

  • Crossover studies are often preferred over parallel-design studies for investigating cardiovascular diseases like hypertension and angina pectoris.
  • Statistical recommendations increasingly advocate for the routine testing of carryover effects in crossover study designs.

Purpose of the Study:

  • To evaluate the adherence to statistical recommendations regarding carryover effects in published crossover studies.
  • To assess the reporting and analysis of carryover effects in cardiovascular research.

Main Methods:

  • A systematic analysis of crossover studies published after November 1985 was conducted.
  • Journals included were two general medical (New England Journal of Medicine, Lancet) and two specialist cardiology journals (Angiology, British Heart Journal).
  • The review focused on whether carryover effects were considered, tested, and reported.

Main Results:

  • Out of 73 analyzed papers, only 23 (32%) considered the possibility of carryover effects.
  • Of those considering carryover effects, 12 papers (16% of total) performed statistical tests.
  • The results of these statistical tests for carryover effects were reported in only 7 papers (10% of total).

Conclusions:

  • There is a significant discrepancy between statistical recommendations and the actual practices in reporting crossover studies in cardiovascular literature.
  • The underreporting and under-testing of carryover effects may impact the validity and interpretation of findings in cardiovascular research.
  • Further emphasis on methodological rigor in crossover trial design and reporting is warranted.

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