Alternatives to the randomized controlled trial Journal Article


Authors: West, S. G.; Duan, N.; Pequegnat, W.; Gaist, P.; Des Jarlais, D. C.; Holtgrave, D.; Szapocznik, J.; Fishbein, M.; Rapkin, B.; Clatts, M.; Mullen, P. D.
Article Title: Alternatives to the randomized controlled trial
Abstract: Public health researchers are addressing new research questions (e.g., effects of environmental tobacco smoke, Hurricane Katrina) for which the randomized controlled trial (RCT) may not be a feasible option. Drawing on the potential outcomes framework (Rubin Causal Model) and Campbellian perspectives, we consider alternative research designs that permit relatively strong causal inferences. In randomized encouragement designs, participants are randomly invited to participate in one of the treatment conditions, but are allowed to decide whether to receive treatment. In quantitative assignment designs, treatment is assigned on the basis of a quantitative measure (e.g., need, merit, risk). In observational studies, treatment assignment is unknown and presumed to be nonrandom. Major threats to the validity of each design and statistical strategies for mitigating those threats are presented.
Keywords: review; united states; outcome assessment; methodology; sensitivity analysis; reproducibility of results; randomized controlled trial; randomized controlled trials as topic; information processing; prediction; health program; health service; depression; statistical analysis; probability; quantitative analysis; medical research; public health; data analysis; patient compliance; clinical research; hospital admission; validity; randomization; research subject; observational study; regression analysis; logistic regression analysis; choice behavior; qualitative research; socioeconomics; behavioral research; education program; parallel design; longitudinal study; sampling; research ethics; mathematical analysis; violence; poverty; internal validity; work; causality; agriculture; childhood mortality; delinquency; gang; epidemiologic research design; research subjects
Journal Title: American Journal of Public Health
Volume: 98
Issue: 8
ISSN: 0090-0036
Publisher: American Public Health Association  
Date Published: 2008-08-01
Start Page: 1359
End Page: 1366
Language: English
DOI: 10.2105/ajph.2007.124446
PUBMED: 18556609
PROVIDER: scopus
PMCID: PMC2446460
DOI/URL:
Notes: --- - "Cited By (since 1996): 46" - "Export Date: 17 November 2011" - "CODEN: AJPEA" - "Source: Scopus"
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  1. Bruce D Rapkin
    45 Rapkin