Evidence map›Paper›PMID 26278881›Full record

SynthesisTrials2015

Stepped wedge randomised controlled trials: systematic review of studies published between 2010 and 2014.

Emma Beard, James J Lewis, Andrew Copas, Calum Davey, David Osrin, Gianluca Baio, Jennifer A Thompson, Katherine L Fielding, Rumana Z Omar, Sam Ononge and 2 more

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04789902 (A Stepped Wedge Cluster Randomized Trial Designed to Evaluate the Effects of SurgeCon), which is not on this map. Cited by 80 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 6 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.

NCT04789902 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

A Stepped Wedge Cluster Randomized Trial Designed to Evaluate the Effects of SurgeCon: A Quality Improvement Surge Management Platform

TypeinterventionalSponsorMemorial University of NewfoundlandRan2021 to 2026Enrolled436,052ConditionsLength of Stay, Emergency DepartmentsArmsSurgeCon
3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Emma BeardDepartment of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. e.beard@ucl.ac.uk.
James J LewisMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. James.Lewis@lshtm.ac.uk.
Andrew CopasMRC Clinical Trials Unit at University College London, 175 Tottenham Court Road, London, W1T 7NU, UK. a.copas@ucl.ac.uk.
Calum DaveyDepartment of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. calum.davey@lshtm.ac.uk.
David OsrinInstitute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK. d.osrin@ucl.ac.uk.
Gianluca BaioDepartment of Statistical Science, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. g.baio@ucl.ac.uk.
Jennifer A ThompsonMRC Clinical Trials Unit at University College London, 175 Tottenham Court Road, London, W1T 7NU, UK. Jennifer.Thompson@lshtm.ac.uk.
Katherine L FieldingMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Katherine.Fielding@lshtm.ac.uk.
Rumana Z OmarDepartment of Statistical Science, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. r.omar@ucl.ac.uk.
Sam OnongeDepartment of Obstetrics and Gynaecology, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda. ononge2006@yahoo.com.
James HargreavesDepartment of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. James.Hargreaves@lshtm.ac.uk.
Audrey ProstInstitute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK. audrey.prost@ucl.ac.uk.

Funding

Cancer Research UKMedical Research Council MC_UU_12023/29Medical Research Council MR/K007467/1Medical Research Council MR/K012126/1Wellcome Trust 091561Wellcome Trust 091561/Z/10/ZWellcome Trust 100714
6 · The paper itself

Abstract

backgroundIn a stepped wedge, cluster randomised trial, clusters receive the intervention at different time points, and the order in which they received it is randomised. Previous systematic reviews of stepped wedge trials have documented a steady rise in their use between 1987 and 2010, which was attributed to the design's perceived logistical and analytical advantages. However, the interventions included in these systematic reviews were often poorly reported and did not adequately describe the analysis and/or methodology used. Since 2010, a number of additional stepped wedge trials have been published. This article aims to update previous systematic reviews, and consider what interventions were tested and the rationale given for using a stepped wedge design.

methodsWe searched PubMed, PsychINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Web of Science, the Cochrane Library and the Current Controlled Trials Register for articles published between January 2010 and May 2014. We considered stepped wedge randomised controlled trials in all fields of research. We independently extracted data from retrieved articles and reviewed them. Interventions were then coded using the functions specified by the Behaviour Change Wheel, and for behaviour change techniques using a validated taxonomy.

resultsOur review identified 37 stepped wedge trials, reported in 10 articles presenting trial results, one conference abstract, 21 protocol or study design articles and five trial registrations. These were mostly conducted in developed countries (n = 30), and within healthcare organisations (n = 28). A total of 33 of the interventions were educationally based, with the most commonly used behaviour change techniques being 'instruction on how to perform a behaviour' (n = 32) and 'persuasive source' (n = 25). Authors gave a wide range of reasons for the use of the stepped wedge trial design, including ethical considerations, logistical, financial and methodological. The adequacy of reporting varied across studies: many did not provide sufficient detail regarding the methodology or calculation of the required sample size.

conclusionsThe popularity of stepped wedge trials has increased since 2010, predominantly in high-income countries. However, there is a need for further guidance on their reporting and analysis.

Indexed as

Research DesignHumansPatient SelectionRandomized Controlled Trials as TopicResearch Support as TopicSample SizeSocioeconomic FactorsTime Factors

Identifiers

PMID26278881
PMCPMC4538902

What OpenQuestion holds

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Registered trials

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.