The regression discontinuity design showed to be a valid alternative to a randomized controlled trial for estimating treatment effects

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

[img] Text
1-s2.0-S0895435616306825-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (281kB) | Request a copy

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

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:

26 Mar 2018 14:17

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

Actions (login required)

Edit item Edit item
Provide Feedback