Choosing the Correct Unit of Analysis in Medical Care Experiments

The statistical methodology of health research experiments published in Lancet, the New England Journal of Medicine, and Medical Care between 1975 and 1980 for the presence or absence of an error of experimental design and analysis was examined. The error is the result of inappropriately using patient-related observations as the unit of analysis to form conclusions about provider behavior or outcomes determined jointly by patients and providers. The error was present in 20 of 28 (71%) health care experiments addressing an issue of health provider professional performance. Its usual effect is to increase erroneously the power of an experiment to detect differences between experimental and control groups. It is likely that this type of error could be avoided by the explicit and prospective definition of hypotheses and the populations to which they are intended to pertain

Control (management) · Error Analysis · Health care · Medical care · Medical research · MEDLINE · Power (physics) · Research design · Statistical analysis · Statistical power · Statistics · Type I and type II errors · Unit (ring theory) · Artificial Intelligence · Computer Science · Healthcare Policy and Management · Mathematics · Medicine · Meta-analysis and systematic reviews · Nursing · Primary Care and Health Outcomes · Psychology

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• Reducing Lengths of Stay in the Coronary Care Unit With a Practice Guideline for Patients With Congestive Heart Failure Insights From a Controlled Clinical Trial

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  Edward H Yelin, Martin A Shearn et al.•Medical Care•1986

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• Physician Characteristics and the Recognition of Depression and Anxiety in Primary Care

  James M Robbins, L J Kirmayer et al.•Medical Care•1994

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• A Typology of Medicaid Managed Care

  Robert E Hurley, Deborah A Freund•Medical Care•1988

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• Effectiveness and efficiency of guideline dissemination and implementation strategies

  Open Access•Jeremy M Grimshaw, J Grimshaw et al.•Health Technology Assessment•2004

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• Closing the gap between research and practice

  Open Access•Lisa A Bero, Lisa Bero et al.•BMJ•1998

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  Open Access•Charles Maynard, Scott D Ramsey et al.•Maternal and Child Health Journal•2000

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• Assessing the Influence of Adult Day Care on Client Satisfaction

  Open Access•Janet R Buelow, Kendon J Conrad•Journal of Aging and Health•1992

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• Design and Analysis of Group-Randomized Trials

  David M Murray, Sherri P Varnell et al.•American Journal of Public Health•2004

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• Evaluation of a public-private certified nurse-midwife maternity program for indigent women

  Dennis Lenaway, Thomas D Koepsell et al.•American Journal of Public Health•1998

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• Changing Provider Behavior

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• Addressing the Unit of Analysis in Medical Care Studies

  Aaron W Calhoun, Gordon H Guyatt et al.•Medical Care•2008

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  Endel John Orav, ELIZABETH A WRIGHT et al.•Medical Care•1996

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• The relevance of client-centered communication to family planning settings in developing countries

  Open Access•Nahla Abdel-Tawab, Nahla Abdel‐tawab et al.•Social Science & Medicine•2002

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• Impact of a Primary Care Group Practice on Emergency Room Utilization at a Community Hospital

  Ralph Ullman, James A Block et al.•Medical Care•1978

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  Sang-O Rhee, Thomas Lyons et al.•Medical Care•1978

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• A Controlled Experiment to Evaluate the Use of a Time-Oriented Summary Medical Record

  Quinn E Whiting-O??keefe, Quinn E Whiting-O keefe et al.•Medical Care•1980

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  Sang-O Rhee, Roice D Luke et al.•Medical Care•1980

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  Fredric J Romm, Barbara S Hulka•Medical Care•1979

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  Donald L Patrick, Jeff Eagle et al.•Medical Care•1978

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  Thomas R Willemain, Roger B Mark•Medical Care•1980

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