Trials which randomize practices I: how should they be analysed?

Family Practice
S M Kerry, J M Bland

Abstract

In some general practice intervention trials, patients must be randomized in practices rather than individually, and this must be taken into account in the analysis. In this article we aim to show how failure to do this may lead to spurious statistical significance and CIs which are narrower than they should be, and to describe the use of summary measures for each practice as a simple method of analysis. The statistical issues are demonstrated by an example of a trial in general practice. The choice of unit of analysis will be most important where there are large numbers of patients recruited from each practice or a high degree of variability between practices.

Citations

Jun 10, 2006·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Christian KronborgKirsten Avlund
Apr 12, 2000·Family Practice·M K CampbellM Eccles
Mar 28, 2008·BMJ : British Medical Journal·Sandra EldridgeGene Feder
Jan 27, 2004·Journal of Neurology, Neurosurgery, and Psychiatry·S C Lewis, C P Warlow
Nov 28, 2012·PLoS Medicine·Charles WeijerUNKNOWN Ottawa Ethics of Cluster Randomized Trials Consensus Group
Mar 5, 2004·American Journal of Public Health·David M MurrayJonathan L Blitstein
Sep 12, 2008·Pain Practice : the Official Journal of World Institute of Pain·Rod Taylor
Aug 30, 2008·Contemporary Clinical Trials·Hrishikesh ChakrabortyLinda L Wright
Sep 17, 2004·Scandinavian Journal of Primary Health Care·Morten Bondo ChristensenFrede Olesen
Sep 1, 2006·International Journal of Epidemiology·Sandra M EldridgeSally Kerry
Jan 5, 2002·The British Journal of Psychiatry : the Journal of Mental Science·Simon Gilbody, Paula Whitty
Nov 12, 2005·Clinical Trials : Journal of the Society for Clinical Trials·Sandra M EldridgeObioha C Ukoumunne
Dec 13, 2000·Statistics in Medicine·D G Altman

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