ArticleTrials2021
Power and sample size calculation for stepped-wedge designs with discrete outcomes.
Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Health Literacy and Oral Health Behaviors Among Dental Medicine Students: A Cross-Sectional Study.Dentistry journal · 2026Article
- Sociodemographic Determinants of Knowledge and Risk Perception Regarding Community Fluoridation: A Cross-Sectional Study in Iași, Romania.Epidemiologia (Basel, Switzerland) · 2026Article
- Measuring Digital Oral Health Literacy in the Social Media Era: Psychometric Validation of the Romanian Version of the Social Media Oral Health Literacy Questionnaire (SMOHLQ).Dentistry journal · 2026Article
- Dietary Behaviors, Sugar Intake, and Public Awareness of Nutritional Labeling Among Young Adults: Implications for Oral and Systemic Health.Nutrients · 2025Article
- What scientific inferences can be made with randomized implementation rollout trials.Implementation science : IS · 2025Article
- Associations Between Smoking, Stress, Quality of Life, and Oral Health Among Dental Students in Romania: A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2025Article
- Psychosocial Determinants of Patient Satisfaction in Orthodontic Treatment: A Pilot Cross-Sectional Survey in North-Eastern.Medicina (Kaunas, Lithuania) · 2025Article
- A Cross-Sectional Study on the Impact of Dental Fear and Anxiety on the Quality of Life of Romanian Dental Students.Medicina (Kaunas, Lithuania) · 2025Article
- Article
- Sample Size Calculations for Stepped Wedge Designs with Treatment Effects that May Change with the Duration of Time under Intervention.Prevention science : the official journal of the Society for Prevention Research · 2024Article
- Systems analysis and improvement approach to optimize tuberculosis (SAIA-TB) screening, treatment, and prevention in South Africa: a stepped-wedge cluster randomized trial.Implementation science communications · 2024Article
- Predictors of Oral Health Behaviors among Dental Students.Medicina (Kaunas, Lithuania) · 2023Article
- Trends in Access to Oral Health Care among Adults from the N-E Region of Romania.Medicina (Kaunas, Lithuania) · 2022Article
- Sample size calculators for planning stepped-wedge cluster randomized trials: a review and comparison.International journal of epidemiology · 2022Review
- A Cross-Sectional, Questionnaire-Based Survey on Air Infection Control among Romanian People.International journal of environmental research and public health · 2022Article
- A Cross-Sectional Questionnaire-Based Survey on Blood-Borne Infection Control among Romanian Dental Students.Medicina (Kaunas, Lithuania) · 2022Article
- Evaluation of the Efficiency of Hand Hygiene Technique with Hydroalcoholic Solution by Image Color Summarize.Medicina (Kaunas, Lithuania) · 2022Article
- Knowledge Level on Infection Control among Romanian Undergraduate and Postgraduate Dental Students.Medicina (Kaunas, Lithuania) · 2022Article
- Power calculation for analyses of cross-sectional stepped-wedge cluster randomized trials with binary outcomes via generalized estimating equations.Statistics in medicine · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundStepped-wedge designs (SWD) are increasingly used to evaluate the impact of changes to the process of care within health care systems. However, to generate definitive evidence, a correct sample size calculation is crucial to ensure such studies are properly powered. The seminal work of Hussey and Hughes (Contemp Clin Trials 28(2):182-91, 2004) provides an analytical formula for power calculations with normal outcomes using a linear model and simple random effects. However, minimal development and evaluation have been done for power calculation with non-normal outcomes on their natural scale (e.g., logit, log). For example, binary endpoints are common, and logistic regression is the natural multilevel model for such clustered data.
methodsWe propose a power calculation formula for SWD with either normal or non-normal outcomes in the context of generalized linear mixed models by adopting the Laplace approximation detailed in Breslow and Clayton (J Am Stat Assoc 88(421):9-25, 1993) to obtain the covariance matrix of the estimated parameters.
resultsWe compare the performance of our proposed method with simulation-based sample size calculation and demonstrate its use on a study of patient-delivered partner therapy for STI treatment and a study that assesses the impact of providing additional benchmark prevalence information in a radiologic imaging report. To facilitate adoption of our methods we also provide a function embedded in the R package "swCRTdesign" for sample size and power calculation for multilevel stepped-wedge designs.
conclusionsOur method requires minimal computational power. Therefore, the proposed procedure facilitates rapid dynamic updates of sample size calculations and can be used to explore a wide range of design options or assumptions.
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