Is a waiting list control group a quasi-experimental design?

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Steve Simon, P.Mean Consulting

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Aug 31, 2010, 11:48:22 PM8/31/10
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I'm helping with a grant and the person writing the grant describes the
waiting list control group as a quasi-experimental design. I say no,
there's nothing "quasi" about it. It's as good as any other randomized
design, with the one caveat that it can't detect changes in the long
term, only the short term. What do you all think?

Just to be sure I'm describing things properly, there are a large number
of practices that are being studied. We randomly assign half of the
practices to receive the intervention at the beginning of year 2. The
other half receives the intervention at the beginning of year 3. For
every practice, we get a full year's worth of data in years 1, 2, and 3.

Thanks in advance for your help.
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ציפי שוחט

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Sep 1, 2010, 1:15:46 AM9/1/10
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Good Morning Simon
 
There might be a concern with larger dropout or other changes affecting the "waiting list" that may affect the balance of the original randomization proccess. In addition - is it possible that changes in the first year practices may affect 3'rd year practices before they enroll in the study?
 
I was involved in a simlar "delayed start" study, where all study subjects were followed for efficacy from the day of randomization. Maybe this could help you.
 
Tzippy Shochat

2010/9/1 Steve Simon, P.Mean Consulting <n...@pmean.com>

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Bland, M.

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Sep 1, 2010, 5:09:55 AM9/1/10
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If you use just the Year 2 data, this is an ordinary cluster randomised
trial and certainly not quasi-experimental. You can use all three years
of data, in which case it is a stepped wedge design.

See e.g.:

The stepped wedge trial design: a systematic review
Celia A Brown and Richard J Lilford
BMC Medical Research Methodology 2006, 6:54 doi:10.1186/1471-2288-6-54

Design and analysis of stepped wedge cluster randomized trials
Michael A. Hussey, James P. Hughes
Contemporary Clinical Trials 28 (2007) 182�191

Martin

Steve Simon, P.Mean Consulting wrote:
> I'm helping with a grant and the person writing the grant describes
> the waiting list control group as a quasi-experimental design. I say
> no, there's nothing "quasi" about it. It's as good as any other
> randomized design, with the one caveat that it can't detect changes in
> the long term, only the short term. What do you all think?
>
> Just to be sure I'm describing things properly, there are a large
> number of practices that are being studied. We randomly assign half of
> the practices to receive the intervention at the beginning of year 2.
> The other half receives the intervention at the beginning of year 3.
> For every practice, we get a full year's worth of data in years 1, 2,
> and 3.
>
> Thanks in advance for your help.

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Dept. of Health Sciences
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Email: mb...@york.ac.uk
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Kornbrot, Diana

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Sep 1, 2010, 10:07:40 AM9/1/10
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I agree it IS an experimental, not a quasi experimental, design.
Assuming that there are enough practices that mean differences across randomly assigned practices are indeed random.

The problem is explaining this to your colleague. In ‘typical’ waiting list designs, people in ONE practice on waiting list are compared with treated people in same practice. That is quasi, as there may be differences between groups on other variables, such as seriousness of condition, age, sex, etc. Consequently, waiting list designs get uniformly labelled ‘quasi’.

The difficulty is explaining this clearly, not only to your colleague, but also to the grant awarder’s referees, who may also be labouring under delusion that all waiting list  designs are quasi experimental

Good luck!!

Best

Diana



On 01/09/2010 10:09, "Bland, M." <mb...@york.ac.uk> wrote:

If you use just the Year 2 data, this is an ordinary cluster randomised
trial and certainly not quasi-experimental. You can use all three years
of data, in which case it is a stepped wedge design.

See e.g.:

The stepped wedge trial design: a systematic review
Celia A Brown and Richard J Lilford
BMC Medical Research Methodology 2006, 6:54 doi:10.1186/1471-2288-6-54

Design and analysis of stepped wedge cluster randomized trials
Michael A. Hussey, James P. Hughes
Contemporary Clinical Trials 28 (2007) 182–191
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Brett Magill

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Sep 2, 2010, 12:16:55 AM9/2/10
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You do have one potential confounder to deal with. Depending on what
is being studied, time (or more specifically history) may or may not
be a significant factor. It's likely you can discard this as a
concern for most applications. Biological processes aren't likely to
respond to political climates or historical events. But if you're
studying a social or psychological phenomena, this could be an
important issue.

On Wed, Sep 1, 2010 at 4:09 AM, Bland, M. <mb...@york.ac.uk> wrote:
> If you use just the Year 2 data, this is an ordinary cluster randomised
> trial and certainly not quasi-experimental. You can use all three years of
> data, in which case it is a stepped wedge design.
>
> See e.g.:
>
> The stepped wedge trial design: a systematic review
> Celia A Brown and Richard J Lilford
> BMC Medical Research Methodology 2006, 6:54 doi:10.1186/1471-2288-6-54
>
> Design and analysis of stepped wedge cluster randomized trials
> Michael A. Hussey, James P. Hughes

> Contemporary Clinical Trials 28 (2007) 182–191
>
> Martin

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