Maas, Iris L.; Nolte, Sandra; Walter, Otto B.; Berger, Thomas; Hautzinger, Martin; Hohagen, Fritz; Lutz, Wolfgang; Meyer, Björn; Schröder, Johanna; Späth, Christina; Klein, Jan Philipp; Moritz, Steffen; Rose, Matthias (2017). The regression discontinuity design showed to be a valid alternative to a randomized controlled trial for estimating treatment effects. Journal of clinical epidemiology, 82, pp. 94-102. Elsevier 10.1016/j.jclinepi.2016.11.008
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Objectives:
To compare treatment effect estimates obtained from a regression discontinuity (RD) design with results from an actual randomized controlled trial (RCT).
Study Design and Setting:
Data from an RCT (EVIDENT), which studied the effect of an Internet intervention on depressive symptoms measured with the Patient Health Questionnaire (PHQ-9), were used to perform an RD analysis, in which treatment allocation was determined by a cutoff value at baseline (PHQ-9 = 10). A linear regression model was fitted to the data, selecting participants above the cutoff who had received the intervention (n = 317) and control participants below the cutoff (n = 187). Outcome was PHQ-9 sum score 12 weeks after baseline. Robustness of the effect estimate was studied; the estimate was compared with the RCT treatment effect.
Results:
The final regression model showed a regression coefficient of −2.29 [95% confidence interval (CI): −3.72 to −.85] compared with a treatment effect found in the RCT of −1.57 (95% CI: −2.07 to −1.07).
Conclusion:
Although the estimates obtained from two designs are not equal, their confidence intervals overlap, suggesting that an RD design can be a valid alternative for RCTs. This finding is particularly important for situations where an RCT may not be feasible or ethical as is often the case in clinical research settings.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy 07 Faculty of Human Sciences > Institute of Psychology |
UniBE Contributor: |
Berger, Thomas (B) |
Subjects: |
600 Technology > 610 Medicine & health 100 Philosophy > 150 Psychology |
ISSN: |
0895-4356 |
Publisher: |
Elsevier |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Thomas Berger |
Date Deposited: |
29 May 2017 11:53 |
Last Modified: |
29 Mar 2023 23:35 |
Publisher DOI: |
10.1016/j.jclinepi.2016.11.008 |
PubMed ID: |
27865902 |
Uncontrolled Keywords: |
Causal inference; Depression; Nonrandom group assignment; PHQ-9; Randomized controlled trials; Regression discontinuity design |
BORIS DOI: |
10.7892/boris.94894 |
URI: |
https://boris.unibe.ch/id/eprint/94894 |
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