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Cluster randomized trials (CRTs) are commonly used to evaluate educational interventions, particularly their effectiveness. Recently there has been greater emphasis on using these trials to explore cost-effectiveness. However, methods for establishing the power of cluster randomized cost-effectiveness trials (CRCETs) are limited. This study develops power computation formulas and statistical software to help researchers plan two- and three-level CRCETs. We illustrate the application of our formulas and software for the designs of CRCETs and discuss the influence of sample size, nesting effects, covariates, and the covariance between cost and effectiveness measures on the statistical power of cost-effectiveness estimates.

Experimental Design and Statistical Power for Cluster Randomized Cost-Effectiveness Trials