ArticleInjury prevention : journal of the International Society for Child and Adolescent Injury Prevention2026
Evaluation of injury prevention interventions using the stepped wedge cluster randomised trial design: key considerations.
Article in Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Which Small-Sample Correction Should be Used When Analyzing Stepped-Wedge Designs With Time-Varying Treatment Effects?Statistics in medicine · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInjury prevention interventions are often implemented at the group level via communities, hospitals, schools, etc, making cluster randomisation a suitable approach to evaluation. The stepped-wedge cluster randomised trial (SW-CRT) design has become increasingly popular for evaluating interventions in real-world settings.
methodIn this commentary, we describe the methodological characteristics of the SW-CRT design and highlight key threats to validity, relevant design and analytical issues, and scenarios in which the SW-CRT design might be a reasonable design choice. We illustrate these key points using a recently completed SW-CRT: the prehospital Canadian C-Spine trial.
resultsSeven potential biases associated with SW-CRTs, including: (1) secular trends, (2) confounding by external factors, (3) identification and recruitment bias, (4) contamination, (5) late and early transitioning, (6) risks of baseline imbalances due to small numbers of clusters and (7) statistical issues are discussed, along with potential mitigation strategies.
conclusionThe SW-CRT design offers a pragmatic approach to evaluating injury prevention interventions that may involve a staggered rollout across services or regions. The design allows an intervention to be rolled out to all participating sites and provides an opportunity to efficiently evaluate effectiveness. It is important, however, for researchers to consider the unique design and analytic issues associated with the SW-CRT design. Mitigating potential threats to validity when using the SW-CRT design helps ensure robust evaluation of injury prevention interventions.
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