Evidence map›Paper›PMID 25555446›Full record

ReviewJournal of pain and symptom management2015

Which treatment is better? Ascertaining patient preferences with crossover randomized controlled trials.

David Hui, Donna S Zhukovsky, Eduardo Bruera

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of pain and symptom management, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  14. Comparison of Treatment Modality Crossovers in Telehealth and In-Person Behavioral Health Treatment in Rural Communities.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

David HuiDepartment of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. Electronic address: dhui@mdanderson.org.
Donna S ZhukovskyDepartment of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Eduardo BrueraDepartment of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Parenteral Hydration in Advanced Cancer Patients: A Randomized Controlled TrialR01CA122292 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BRUERA, EDUARDO · 2006 to 2009
$2.2M
Methylphenidate for Fatigue in Advanced Cancer PatientsR01NR010162 · NINR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BRUERA, EDUARDO · 2006 to 2009
$1.3M
Morphine versus Methadone as First Line Strong Opioid for Cancer PainR01CA124481 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BRUERA, EDUARDO · 2007 to 2009
$1.2M
NCI NIH HHS CA 016672NCI NIH HHS P30 CA016672NCI NIH HHS R01 CA122292NCI NIH HHS R01CA122292-01NCI NIH HHS R01 CA124481NCI NIH HHS R01CA124481-01NINR NIH HHS R01 NR010162NINR NIH HHS R01NR010162-01A1
6 · The paper itself

Abstract

contextThe difference in patient-reported outcomes between study arms can often be difficult to ascertain in randomized controlled trials (RCTs) using a parallel design because of wide interindividual variations in baseline characteristics and how patients interpret the outcome measures. Furthermore, the minimal clinically significant difference is often not available for many outcomes, and even when available, not individualized for each patient. Crossover RCTs are designed for intraindividual comparisons, which can address these issues by asking patients to directly compare the interventions with regard to effectiveness, adverse effects, and ease of use and to provide an overall choice.

objectivesWe discuss the key design elements for crossover trials, their advantages and disadvantages relative to parallel designs, and their utility in palliative care research using a number of case examples.

methodsThis is a narrative review.

resultsCrossover studies randomize patients to a sequence of treatments. In addition to facilitating intraindividual comparisons, they often require a smaller sample size for the same statistical power compared with parallel designs and are thus less costly. However, crossover studies are only feasible when the condition being studied is relatively stable and the intervention has a short-term effect. Crossover studies with inadequate washout periods may be difficult to interpret. The risk of attrition also may increase because of prolonged study duration.

conclusionBy facilitating intraindividual comparisons and eliciting patient preferences, crossover studies can provide unique information on the superior intervention. Crossover designs should be considered for selected palliative care studies.

Indexed as

Cross-Over StudiesPatient PreferenceRandomized Controlled Trials as TopicHumansPalliative CareResearch DesignClinical trialscrossover studiespalliative carerandomized controlled trialresearch designstatistical data interpretation

Identifiers

PMID25555446
PMCPMC4359650

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.