Loading....
Coupon Accepted Successfully!

PSM

Open Flashcards

Epidemiology

Question
112 out of 184
 

Which of the following statements is not true with regard to the crossover study design:



A Washout period is important

B Each case acts as its own control

C Can be used to compare medical and surgical

treatment regimens

D Minimizes confounding

Ans. C Can be used to compare medical and surgical treatment regimens

A crossover study (also referred to as a crossover trial) is a longitudinal study in which subjects receive a sequence of different treatments (or exposures).

Randomized, controlled, crossover experiments are especially important in health-care. In a randomized clinical trial, the subjects are randomly assigned treatments. When the randomized clinical trial is a repeated measures design, the subjects are randomly assigned to a sequence of treatments. A crossover clinical trial is a repeated measures design in which each patient is randomly assigned to a sequence of treatments, including at least two treatments (of which one "treatment" may be a standard treatment or a placebo).

Nearly all crossover designs have "balance", which means that all subjects should receive the same number of treatments and that all subjects participate for the same number of periods. In most crossover trials, in fact, each subject receives all treatments.

Advantages

A crossover study has two advantages over a non-crossover longitudinal study:

1. First, the influence of confounding covariates is reduced because each crossover patient serves as his or her own control. In a non-crossover study, even randomized, it is often the case that different treatment-groups are found to imbalanced on some covariates. In a controlled, randomized crossover designs, such imbalances are implausible (unless covariates were to change systematically during the study).

2. Second, optimal crossover designs are statistically efficient and so require fewer subjects than do non-crossover designs (even other repeated measures designs).

Crossover studies often have two problems:

First is the issue of "order" effects, because it is possible that the order in which treatments are administered may affect the outcome.

Second is the issue of "carry-over" between treatments, which confounds the estimates of the treatment effects. In practice, "carry-over" effects can be avoided with a sufficiently long "wash-out" period between treatments. However, the planning for sufficiently long wash-out periods does require expert knowledge of the dynamics of the treatment, which often is unknown, of course.

Epidemiology Flashcard List

184 flashcards
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
21)
22)
23)
24)
25)
26)
27)
28)
29)
30)
31)
32)
33)
34)
35)
36)
37)
38)
39)
40)
41)
42)
43)
44)
45)
46)
47)
48)
49)
50)
51)
52)
53)
54)
55)
56)
57)
58)
59)
60)
61)
62)
63)
64)
65)
66)
67)
68)
69)
70)
71)
72)
73)
74)
75)
76)
77)
78)
79)
80)
81)
82)
83)
84)
85)
86)
87)
88)
89)
90)
91)
92)
93)
94)
95)
96)
97)
98)
99)
100)
101)
102)
103)
104)
105)
106)
107)
108)
109)
110)
111)
112)
113)
114)
115)
116)
117)
118)
119)
120)
121)
122)
123)
124)
125)
126)
127)
128)
129)
130)
131)
132)
133)
134)
135)
136)
137)
138)
139)
140)
141)
142)
143)
144)
145)
146)
147)
148)
149)
150)
151)
152)
153)
154)
155)
156)
157)
158)
159)
160)
161)
162)
163)
164)
165)
166)
167)
168)
169)
170)
171)
172)
173)
174)
175)
176)
177)
178)
179)
180)
181)
182)
183)
184)