使用阶梯集群随机试验设计评估伤害预防干预措施:关键考虑因素
Yongdong Ouyang1,2, Christian Vaillancourt3,4,5, Anna Heath6,7,8
1Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
阶梯集群随机试验 (SW-CRT) 是评估小组级伤害预防干预措施的有价值的设计. 仔细考虑潜在的偏见和分析问题对于强有力的干预评估至关重要.
科学领域:
- 流行病学 流行病学
- 公共卫生研究方法 公共卫生研究方法
背景情况:
- 诸如伤害预防之类的群体级干预措施通常使用集群随机化进行评估.
- 阶梯集群随机试验 (SW-CRT) 设计越来越多地用于现实世界的干预评估.
研究的目的:
- 描述SW-CRT设计的方法特性.
- 突出对有效性的关键威胁以及相关的设计/分析问题.
- 确定SW-CRT是一个合适的设计选择的场景.
主要方法:
- 描述SW-CRT方法的评论.
- 使用医院前加拿大C-脊柱试验的插图.
- 讨论潜在的偏见和缓解策略.
主要成果:
- 在SW-CRT中发现了七个潜在的偏差:世俗趋势,外部混,招聘偏差,污染,过渡问题,基线不平衡和统计挑战.
- 讨论了这些偏见的缓解策略.
结论:
- SW-CRT是一种实用设计,用于评估伤害预防干预措施的分阶段推出.
- 设计允许在所有地点有效性进行高效的评估.
- 解决SW-CRT特定的设计和分析问题对于有效的结果至关重要.
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