ArticleBMC medical research methodology2020
The hunt for efficient, incomplete designs for stepped wedge trials with continuous recruitment and continuous outcome measures.
Article in BMC medical research methodology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Factors affecting power in stepped wedge trials when the treatment effect varies with time.Trials · 2026Article
- Article
- Optimal Allocation of Observations in Stepped-Wedge and Other Cluster Studies With Correlated Cluster-Period Effects.Statistics in medicine · 2025Article
- The relative efficiency of staircase and stepped wedge cluster randomised trial designs.Statistical methods in medical research · 2025Article
- Designing stepped wedge trials to evaluate physical activity interventions in schools: methodological considerations.The international journal of behavioral nutrition and physical activity · 2025Article
- Efficient designs for three-sequence stepped wedge trials with continuous recruitment.Clinical trials (London, England) · 2024Article
- Adherence to key recommendations for design and analysis of stepped-wedge cluster randomized trials: A review of trials published 2016-2022.Clinical trials (London, England) · 2024Review
- Information content of stepped wedge designs under the working independence assumption.Journal of statistical planning and inference · 2024Article
- The staircase cluster randomised trial design: A pragmatic alternative to the stepped wedge.Statistical methods in medical research · 2024Article
- Optimal study designs for cluster randomised trials: An overview of methods and results.Statistical methods in medical research · 2023Review
- The thriving kids and parents schools project: protocol of an incomplete stepped wedged cluster randomised trial evaluating the effectiveness of a Triple P seminar series.BMC public health · 2023Article
- Generalizing the information content for stepped wedge designs: A marginal modeling approach.Scandinavian journal of statistics, theory and applications · 2023Article
- The impact of iterative removal of low-information cluster-period cells from a stepped wedge design.BMC medical research methodology · 2023Article
- Enhancing doctor-patient relationships in community health care institutions: the Patient Oriented Four Habits Model (POFHM) trial-a stepped wedge cluster randomized trial protocol.BMC psychiatry · 2023Article
- Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol.BMC palliative care · 2023Article
- Evaluation of combinatorial optimisation algorithms for c-optimal experimental designs with correlated observations.Statistics and computing · 2023Article
- Sample size calculators for planning stepped-wedge cluster randomized trials: a review and comparison.International journal of epidemiology · 2022Review
- Trials with repeated cross sections: alternatives to parallel group designs in surgery trials.Techniques in coloproctology · 2022Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundWe consider the design of stepped wedge trials with continuous recruitment and continuous outcome measures. Suppose we recruit from a fixed number of clusters where eligible participants present continuously, and suppose we have fine control over when each cluster crosses to the intervention. Suppose also that we want to minimise the number of participants, leading us to consider "incomplete" designs (i.e. without full recruitment). How can we schedule recruitment and cross-over at different clusters to recruit efficiently while achieving good precision?
methodsThe large number of possible designs can make exhaustive searches impractical. Instead we consider an algorithm using iterative improvements to hunt for an efficient design. At each iteration (starting from a complete design) a single participant - the one with the smallest impact on precision - is removed, and small changes preserving total sample size are made until no further improvement in precision can be found.
resultsStriking patterns emerge. Solutions typically focus recruitment and cross-over on the leading diagonal of the cluster-by-time diagram, but in some scenarios clusters form distinct phases resembling before-and-after designs.
conclusionsThere is much to be learned about optimal design for incomplete stepped wedge trials. Algorithmic searches could offer a practical approach to trial design in complex settings generally.
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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.