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Waiting list Randomized controlled trial within a case-finding design: Methodological considerations

Lookup NU author(s): Professor Joy Adamson


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© 2014 John Wiley & Sons, Ltd.Rationale, aims and objectives: Randomized controlled trials (RCTs) are widely used in health care research to provide high-quality evidence of effectiveness of an intervention. However, sometimes a study does not require an RCT in order to answer its primary objective; a case-finding design may be more appropriate. The aim of this paper was to introduce a new study design that nests a waiting list RCT within a case-finding study. Methods: An example of the new study design is the DOC Study, which primarily aims to determine the diagnostic accuracy of lung function tests for chronic obstructive pulmonary disease. It also investigates the impact of lung function tests on smoking behaviour through use of a waiting list design. The first step of the study design is to obtain participants' consent. Individuals are then randomized to one of two groups; either the 'intervention now' group or the 'intervention later' group, that is, participants are placed on a waiting list. All participants receive the same intervention; the only difference between the groups is the timing of the intervention. Results and conclusions: The design addresses patient preference issues and recruitment issues that can arise in other trial designs. Potential limitations include differential attrition between study groups and potential demoralization for the 'intervention later' group. The 'waiting list case-finding trial' design is a valuable method that could be applied to case-finding studies; the design enables the case-finding component of a study to be maintained while simultaneously exploring additional hypotheses through conducting a trial.

Publication metadata

Author(s): Ronaldson S, Adamson J, Dyson L, Torgerson D

Publication type: Article

Publication status: Published

Journal: Journal of Evaluation in Clinical Practice

Year: 2014

Volume: 20

Issue: 5

Pages: 601-605

Print publication date: 01/10/2014

Online publication date: 18/06/2014

Acceptance date: 02/04/2014

ISSN (print): 1356-1294

ISSN (electronic): 1365-2753

Publisher: John Wiley & Sons Ltd


DOI: 10.1111/jep.12161

PubMed id: 24943741


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