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- W841192676 abstract "This thesis addresses the evaluation of complex interventions using routinely collected data,specifically the internal validity of observational studies and the generalisability of RandomisedControlled Trials (RCTs). Following a literature review, this thesis has four main objectives: toestimate the effect of telephone health coaching on hospital utilisation in an observational study; toassess optimal choices of control area in observational studies; to estimate the effect of telehealthwithin a large RCT; and to develop methods to assess aspects of the generalisability of RCTsempirically.The first paper compares health-coached patients with matched controls. Controls were selectedfrom areas of England that were first matched to the characteristics of the intervention area. Healthcoaching did not reduce hospital admissions in this study. A second paper uses simulations to assessthe relative bias and statistical precision in the treatment effects estimated under alternativeapproaches to selecting control areas. Lower bias is reported when using local controls than whenselecting controls from matched areas, except when there is little unexplained area-level variation inoutcomes, when the opposite is true.The third paper reports that, in the RCT, telehealth patients had fewer hospital admissions thancontrols, but admissions increased unexpectedly among controls after recruitment, leading toconcerns about generalisability. Placebo tests find that control patients in the RCT experienced moreadmissions than matched non-participants receiving usual care. To address the concern that thecontrol group did not receive ‘usual care’, sensitivity analyses are presented that contrast outcomesbetween the telehealth patients in the RCT and matched non-participants. In this comparison,telehealth is associated with a trend towards more admissions than usual care.The thesis concludes that careful control matching and placebo tests can address important aspectsof the validity of observational studies and RCTs, but that further development of evaluationmethods is warranted." @default.
- W841192676 created "2016-06-24" @default.
- W841192676 creator A5056329125 @default.
- W841192676 date "2015-06-04" @default.
- W841192676 modified "2023-09-24" @default.
- W841192676 title "Evaluating complex interventions using routinely collected data : methods to improve the validity of randomised controlled trials and observational studies" @default.
- W841192676 doi "https://doi.org/10.17037/pubs.02212900" @default.
- W841192676 hasPublicationYear "2015" @default.
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