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- W2011366222 abstract "We thank Kotz et al. [ [1] Kotz D. Spigt M. Arts I.C.W. Crutzen R. Viechtbauer W. Use of the stepped wedge design cannot be recommended: a critical appraisal and comparison with the classic cluster randomised controlled trial design. J Clin Epidemiol. 2012; 65: 1249-1252 Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar ] for the interesting commentary on our article [ [2] Mdege N.D. Man M. Taylor C.A. Torgerson D.J. Systematic review of stepped wedge cluster randomized trials shows that design is particularly used to evaluate interventions during routine implementation. J Clin Epidemiol. 2011; 64: 936-948 Abstract Full Text Full Text PDF PubMed Scopus (296) Google Scholar ]. We agree with the authors in a number of areas. First, there is no question that in terms of the hierarchy of evidence, a classic cluster randomized controlled trial (CRCT) is preferred to the stepped wedge CRCT for many of the reasons the authors outline. Second, in an ideal world, an unevaluated intervention should not be given to all potential recipients because we do not know whether it is effective. However, there are some circumstances where the stepped wedge CRCT is preferable to the alternative: no randomized trial at all. Researchers should convince policy makers to perform a classic cluster randomized controlled trial instead of a stepped wedge design when an intervention is rolled outJournal of Clinical EpidemiologyVol. 65Issue 12PreviewWe thank Mdege et al. [1] for their response to our critical appraisal [2] of the stepped wedge design (SWD). They agree with us that the SWD has many disadvantages compared with the cluster randomized controlled trial (cluster RCT) and that the cluster RCT is preferable in most circumstances. However, they also maintain that the SWD may be useful when the alternative is to conduct no randomized trial at all and that some of the cluster RCT variants that we suggest in our article are in fact variants of the SWD. Full-Text PDF" @default.
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- W2011366222 title "There are some circumstances where the stepped-wedge cluster randomized trial is preferable to the alternative: no randomized trial at all. Response to the commentary by Kotz and colleagues" @default.
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