Analysis of cluster randomized trials in primary care: a practical approach

Authors: Campbell, Marion K¹; Mollison, Jill²; Steen, Nick³; Grimshaw, Jeremy M¹

Source: Family Practice, Volume 17, Number 2, April 2000 , pp. 192-196(5)

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Abstract:

Background. Cluster randomized trials increasingly are being used in health services research and in primary care, yet the majority of these trials do not account appropriately for the clustering in their analysis.

Objectives. We review the main implications of adopting a cluster randomized design in primary care and highlight the practical application of appropriate analytical techniques.

Methods. The application of different analytical techniques is demonstrated through the use of empirical data from a primary care-based case study.

Conclusion. Inappropriate analysis of cluster trials can lead to the presentation of inaccurate results and hence potentially misleading conclusions. We have demonstrated that adjustment for clustering can be applied to real-life data and we encourage more routine adoption of appropriate analytical techniques.

Keywords: Analysis approaches; cluster randomized trials; primary care

Document Type: Research article

Affiliations: 1: Health Services Research Unit, University of Aberdeen, 2: Department of Public Health, University of Aberdeen, Aberdeen and 3: Centre for Health Services Research, University of Newcastle, Newcastle, UK.

Publication date: 2000-04-01

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Family Practice is an international journal aimed at practitioners, teachers and researchers in the fields of family medicine, general practice and primary care in both developed and developing countries.