scholarly journals The LOOP Estimator: Adjusting for Covariates in Randomized Experiments

2018 ◽  
Vol 42 (4) ◽  
pp. 458-488 ◽  
Author(s):  
Edward Wu ◽  
Johann A. Gagnon-Bartsch
Keyword(s):  
Variable Selection ◽  
Controlled Trial ◽  
Potential Outcomes ◽  
Prediction Algorithm ◽  
Randomized Experiments ◽  
Randomized Controlled ◽  
Statistical Assumptions ◽  
Leave One Out ◽  
And Control ◽  
Baseline Covariates

Background: When conducting a randomized controlled trial, it is common to specify in advance the statistical analyses that will be used to analyze the data. Typically, these analyses will involve adjusting for small imbalances in baseline covariates. However, this poses a dilemma, as adjusting for too many covariates can hurt precision more than it helps, and it is often unclear which covariates are predictive of outcome prior to conducting the experiment. Objectives: This article aims to produce a covariate adjustment method that allows for automatic variable selection, so that practitioners need not commit to any specific set of covariates prior to seeing the data. Results: In this article, we propose the “leave-one-out potential outcomes” estimator. We leave out each observation and then impute that observation’s treatment and control potential outcomes using a prediction algorithm such as a random forest. In addition to allowing for automatic variable selection, this estimator is unbiased under the Neyman–Rubin model, generally performs at least as well as the unadjusted estimator, and the experimental randomization largely justifies the statistical assumptions made.

Design-Based Covariate Adjustments in Paired Experiments

2020 ◽  
pp. 107699862094146
Author(s):  
Edward Wu ◽  
Johann A. Gagnon-Bartsch
Keyword(s):  
Random Forests ◽  
Potential Outcomes ◽  
Prediction Algorithm ◽  
Randomized Experiments ◽  
Control Groups ◽  
Trade Off ◽  
And Control

In paired experiments, participants are grouped into pairs with similar characteristics, and one observation from each pair is randomly assigned to treatment. The resulting treatment and control groups should be well-balanced; however, there may still be small chance imbalances. Building on work for completely randomized experiments, we propose a design-based method to adjust for covariate imbalances in paired experiments. We leave out each pair and impute its potential outcomes using any prediction algorithm such as lasso or random forests. This method addresses a unique trade-off that exists for paired experiments. By addressing this trade-off, the method has the potential to improve precision over existing methods.

scholarly journals Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

2021 ◽  
pp. 088626052110041
Author(s):  
Roos Ruijne ◽  
Cornelis Mulder ◽  
Milan Zarchev ◽  
Kylee Trevillion ◽  
Roel van Est ◽  
...  
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Referral Rates ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
And Control ◽  
Domestic Violence And Abuse

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

scholarly journals A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial

Metabolites ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 204
Author(s):  
Anissa Aharaz ◽  
Jens Henning Rasmussen ◽  
Helle Bach Ølgaard McNulty ◽  
Arne Cyron ◽  
Pia Keinicke Fabricius ◽  
...  
Keyword(s):  
Pilot Study ◽  
Controlled Trial ◽  
Inappropriate Medication ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Patient Interviews ◽  
Number Of Patients ◽  
Multimorbid Patients ◽  
And Control

Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.

scholarly journals The Repercussion of Ai Chi on Aged People’s Balance

2014 ◽  
Vol 4 (3) ◽  
pp. 247-256
Author(s):  
Pablo Javier Olabe Sánchez ◽  
Andrés Martínez-Almagro Andreo
Keyword(s):  
Fall Prevention ◽  
Controlled Trial ◽  
Intervention Group ◽  
The Other ◽  
Control Group ◽  
Aged People ◽  
Randomized Controlled ◽  
Risk Of Fall ◽  
And Control ◽  
Positive Effect

To practice strength and balance activities are shown as useful tools to fall prevention by diverse metanalysis. On the other side, aquatic environment offers interesting properties for a therapeutic reeducation, being the Ai Chi one of its applications. Aim: To evaluate the repercussion of an Ai Chi programme on aged people’s balance. Method: A randomized controlled trial was developed comparing two groups formed by aged people with risk of fall according to the Timed Up & Go test. Intervention Group (IG) followed twelve Ai Chi sessions combined with their thermal programme; and Control Group (CG) just followed the thermal programme. Both groups spent two weeks in the Balneario of Archena (Murcia, Spain). Results: Both groups improve their balance; however, only the IG reached the non-risk of fall from the Timed Up & Go test. Conclusions: The combination of Ai Chi sessions and a thermal programme had a positive effect on aged people’s balance, showing a therapeutic and clinical relevance.

The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asieh Mehdipour ◽  
Parvin Abedi ◽  
Somayeh Ansari ◽  
Maryam Dastoorpoor
Keyword(s):  
Randomized Controlled Trial ◽  
Postmenopausal Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Moderate Depression ◽  
Before And After ◽  
The Mean ◽  
And Control

Abstract Objectives Postmenopausal women are at greater risk of depression. Depression may negatively affect the quality of life of women. An emotional freedom technique (EFT) is an evidence-based therapy combining cognitive and exposure components with acupressure. This study aimed to evaluate the effect of EFT on depression in postmenopausal women. Methods This was a randomized controlled trial in which 88 women with mild to moderate depression recruited from a menopausal clinic in Ahvaz, Iran, and randomly assigned into two groups of EFT (n=44) and control for sham therapy (n=44). Women in the EFT group received two sessions of training and asked to continue EFT for 8 weeks, one time per day. The Beck Depression Inventory (BDI2) completed by women before and after the intervention. The control group received training on sham acupressure points similar to the intervention group. Data collected using a demographic and BDI2. Women requested to complete the BDI2 before and after the intervention. The independent t-test, chi-square, and ANCOVA were used to analyze data. Results The mean depression score in the intervention group reduced from 20.93 ± 4.6 to 10.96 ± 4.38 in comparison to the control group that reduced from 19.18 ± 2.79 to 17.01 ± 6.05 after intervention (p=0.001). After the 8 week intervention, the frequency of moderate depression decreased from 56.8 to 9.35% in the intervention and from 50 to 29.5% in the control group. In total, 63.4 and 34.15% in the intervention and control groups were free of depression respectively after the intervention (p<0.001). Conclusions The results of this study showed that using EFT for 8 weeks could significantly reduce the mean score of depression in postmenopausal women. Using this method in public health centers for postmenopausal women is recommended.

scholarly journals Achieving equitable uptake of handwashing and sanitation by addressing both supply and demand-based constraints: findings from a randomized controlled trial in rural Bangladesh

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarker Masud Parvez ◽  
Musarrat Jabeen Rahman ◽  
Rashidul Azad ◽  
Mahbubur Rahman ◽  
Leanne Unicomb ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Supply And Demand ◽  
Efficacy Trial ◽  
Experimental Conditions ◽  
Randomized Controlled ◽  
Link Type ◽  
Education Levels ◽  
Change Promotion ◽  
And Control ◽  
The Impact

Abstract Background Supply driven programs that are not closely connected to community demand and demand-driven programs that fail to ensure supply both risk worsening inequity. Understanding patterns of uptake of behaviors among the poorest under ideal experimental conditions, such as those of an efficacy trial, can help identify strategies that could be strengthened in routine programmatic conditions for more equitable uptake. WASH Benefits Bangladesh was a randomized controlled efficacy trial that provided free-of cost WASH hardware along with behavior change promotion. The current paper aimed to determine the impact of the removal of supply and demand constraints on the uptake of handwashing and sanitation behaviors across wealth and education levels. Methods The current analysis selected 4 indicators from the WASH Benefits trial— presence of water and soap in household handwashing stations, observed mother’s hand cleanliness, observed visible feces on latrine slab or floor and reported last child defecation in potty or toilet. A baseline assessment was conducted immediately after enrolment and endline assessment was conducted approximately 2 years later. We compared change in uptake of these indicators including wealth quintiles (Q) between intervention and control groups from baseline to endline. Results For hand cleanliness, the poorest mothers improved more [Q1 difference in difference, DID: 16% (7, 25%)] than the wealthiest mothers [Q5 DID: 7% (− 4, 17%)]. The poorest households had largest improvements for observed presence of water and soap in handwashing station [Q1 DID: 82% (75, 90%)] compared to the wealthiest households [Q5 DID: 39% (30, 50%)]. Similarly, poorer household demonstrated greater reductions in visible feces on latrine slab or floor [Q1DID, − 25% (− 35, − 15) Q2: − 34% (− 44, − 23%)] than the wealthiest household [Q5 DID: − 1% (− 11, 8%). For reported last child defecation in potty or toilet, the poorest mothers showed greater improvement [Q1–4 DID: 50–54% (44, 60%)] than the wealthier mothers [Q5 DID: 39% (31, 46%). Conclusion By simultaneously addressing supply and demand-constraints among the poorest, we observed substantial overall improvements in equity. Within scaled-up programs, a separate targeted strategy that relaxes constraints for the poorest can improve the equity of a program. Trial registration WASH Benefits Bangladesh: ClinicalTrials.gov, identifier: NCT01590095. Date of registration: April 30, 2012 ‘Retrospectively registered’.

scholarly journals The Effectiveness of Auditory Stimuli from Murottal Quran to Improve Comfort and Weight in Low Birth Weight Infants: Randomized Controlled Trial

Jurnal NERS ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 111
Author(s):  
Desriati Devi ◽  
Yeni Rustina ◽  
Defi Efendi
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Controlled Trial ◽  
Auditory Stimuli ◽  
Control Groups ◽  
Low Birth Weight Infants ◽  
Randomized Controlled ◽  
Significant Difference ◽  
And Control

Introduction: Low birth weight (LBW) infants who have been hospitalized are exposed to various conditions that provoke discomfort, which could trigger a stress response and growth disorders. This study aimed to identify the effects of auditory stimuli from Murottal Quran when it comes to the comfort and weight of LBW infants.Methods: This study used a clinical randomized controlled trial design involving 52 low birth weight infants. The infants were randomly assigned to either the intervention group (n=26) or the control (n=26). The intervention of Murottal Quran was given using a speaker 4 times a day for 20 minutes every 3 hours. This intervention was conducted for three days.Results: The results of this study show that there is a significant difference in the comfort of  low birth weight infants after Murottal Qur’an on the first, second, and third days between the intervention and control groups (p=0.014; <0.001; <0.001). There was no significant difference in the weight between the intervention and control groups in the first, second, and third days (p=0.481; 0.481; 0.464).Conclusion: The auditory stimuli of Murottal Quran can help to improve the comfort level of low birth weight infants during hospitalization. It can therefore be used as a supportive therapy to facilitate low birth weight infant and premature infant development.

scholarly journals A randomized controlled trial of combination of peppermint, lavender, and turmeric oil for antipruritic agent in pregnant women

2021 ◽  
Vol 30 (1) ◽  
pp. 39-44
Author(s):  
Fransisca Retno Asih ◽  
Farid Husin ◽  
Oki Suwarsa ◽  
Irda Fidrianny ◽  
Dany Hilmanto
Keyword(s):  
Pregnant Women ◽  
Controlled Trial ◽  
Control Groups ◽  
Analog Scale ◽  
Chi Square ◽  
Herbal Products ◽  
Randomized Controlled ◽  
Level I ◽  
And Control ◽  
Single Blind

BACKGROUND Pruritus is the most common dermatological complaint that occurs during pregnancy, which is around 14–20%. No research related to herbal products to reduce some of the characteristics of pruritus at once has been conducted. This study aimed to assess the effect of blending oil to reduce pruritus based on visual analog scale (VAS). METHODS This was a single-blind, randomized clinical trial that included 57 pregnant women who were at 25–38 weeks of gestation, had a pruritus during pregnancy, a single pregnancy, a level I and II pruritus and a moderate to severe pruritus based on VAS. Pruritus scores were measured using VAS in both the treatment and control groups. The treatment and control groups applied blending oil and placebo, respectively, twice a day after bathing for 2 weeks. Mann–Whitney U, paired t, and chi-square tests were used for the analysis. RESULTS Pruritus reduction in pregnant women who received blending oil was higher than those using placebo (61.08% versus 12.41%, p<0.05). 83% of subjects using blending oils had a reduction of pruritus by >25 mm. Pregnant women who used placebo had a six times greater risk of experiencing pruritus than those who used blending oil (RR = 5.8, 95% CI = 2.613–12.874). CONCLUSIONS Blending oil can be used topically to treat a pruritus in pregnant women.

scholarly journals Effect of sanitation improvements on soil-transmitted helminth eggs in courtyard soil from rural Bangladesh: Evidence from a cluster-randomized controlled trial

2020 ◽  
Author(s):  
Laura H. Kwong ◽  
Debashis Sen ◽  
Sharmin Islam ◽  
Sunny Shahriar ◽  
Jade Benjamin-Chung ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Geometric Mean ◽  
Cluster Randomized Controlled Trial ◽  
Rural Bangladesh ◽  
Randomized Controlled ◽  
Improved Sanitation ◽  
Cluster Randomized ◽  
And Control ◽  
Animal Feces

AbstractImproved sanitation has been hypothesized to reduce soil-transmitted helminth (STH) infections by reducing the prevalence and abundance of STH eggs/larvae in soil. We evaluated the effect of a randomized sanitation program (providing households with an improved dual-pit latrine, tools for child/animal feces management, and behavioral messaging) on reducing STH eggs in soil from household courtyards. We collected soil samples from 1405 households enrolled in the sanitation intervention (n=419) and control (n=914) groups of a cluster-randomized controlled trial (WASH Benefits) in rural Bangladesh approximately 2 years after the initiation of the interventions. We analyzed samples for Ascaris lumbricoides, Trichuris trichiura, and hookworm eggs by microscopy. We estimated prevalence ratios (PR) and relative egg count reductions (ECR) to compare the prevalence of any STH eggs and arithmetic and geometric mean egg counts for any STH per gram of soil between the sanitation and control arms.Among intervention households, latrines achieved high and sustained user uptake by adults while child open defecation remained common and most households did not dispose of child feces hygienically. In courtyard soil from control households, the prevalence of any STH eggs was 75.7% and the prevalence of any larvated STH eggs was 67.3%. A. lumbricoides was detected in 63.0% of control samples and T. trichiura in 55.7% of control samples; hookworm was not detected in any sample. The arithmetic mean egg count for any STH was 3.96 eggs/dry gram, while the geometric mean was 1.58 eggs/dry gram. There was no difference between the intervention and control groups in the prevalence of any STH eggs (PR=0.98 (95% CI: 0.91–1.05)) or mean egg counts (ECR=0.08 (95% CI: −0.10, 0.26) for geometric mean and 0.07 (95% CI: −0.22, 0.37) for arithmetic mean). Adjusted models gave similar results.A compound-level sanitation intervention that provided improved latrines and tools for disposal of child and animal feces did not have an impact on environmental reservoirs of STH eggs. In order to effectively reduce the prevalence and abundance of STH eggs in the environment, sustained, widespread use of sanitation strategies to isolate and hygienically dispose of child and animal feces may need to complement traditional strategies for containment of adult human feces.Author summaryImproved sanitation has been hypothesized to reduce soil-transmitted helminth (STH) infections by reducing the prevalence and abundance of STH eggs/larvae in soil. We evaluated the effect of a randomized sanitation program (providing households with an improved dual-pit latrine, tools for child/animal feces management, and behavioral messaging) on reducing STH eggs in soil from household courtyards. We collected soil samples from 1405 households enrolled in the control and sanitation groups of a cluster-randomized controlled trial (WASH Benefits) in rural Bangladesh approximately 2 years after the initiation of the interventions. We analyzed samples for Ascaris lumbricoides, Trichuris trichiura and hookworm eggs by microscopy. We found no effect of the sanitation intervention on STH eggs in soil. In order to effectively reduce the prevalence and abundance of STH eggs in the environment, sustained, widespread use of sanitation strategies to isolate and hygienically dispose of child and animal feces may need to complement traditional strategies for containment of adult human feces.

Auditory and Visual Executive Functions in Children and Response to Methylphenidate: A Randomized Controlled Trial

2017 ◽  
Vol 24 (2) ◽  
pp. 235-245
Author(s):  
Yaffa Hadar ◽  
Shraga Hocherman ◽  
Oren Lamm ◽  
Emanuel Tirosh
Keyword(s):  
Executive Functions ◽  
Visual Cues ◽  
Controlled Trial ◽  
Crossover Design ◽  
Control Groups ◽  
Children With Adhd ◽  
Randomized Controlled ◽  
The Difference ◽  
Visually Based ◽  
And Control

Objectives: The aim of the study was to assess auditory and visually based executive functions (EFs) and the effect of methylphenidate (MPH) in children with ADHD. Methods: Thirty-six boys between the ages of 8.3 and 9.7 years with ADHD and 36 matched controls were included. The study group was randomized into MPH and placebo for 7 days each in a crossover design. A Cued Choice Reaction Time (CCRT) test that included incongruent cuing was administered at baseline and following 1 and 2 weeks. Results: The difference between the study and control groups was more evident with visual cues and incongruent cuing. Increased gains by children with predominantly hyperactive–impulsive\combined (HI\C) type of ADHD were observed under MPH. Conclusions: The differences between children with ADHD and typical children are more pronounce under incongruent auditory cuing . The gains attributable to MPH are more specific to tasks involving auditory and visual EFs and in children with HI\C type ADHDs.

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