Open AccessPrevention Trials: Their Place in How We Understand the Value of Prevention Strategies
Author(s) -
Graham A. Colditz,
Philip R. Taylor
Publication year - 2010
Publication title -
annual review of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.239
H-Index - 144
eISSN - 1545-2093
pISSN - 0163-7525
DOI - 10.1146/annurev.publhealth.121208.131051
Subject(s) - observational study , randomized controlled trial , psychological intervention , intervention (counseling) , medicine , public health , psychology , family medicine , nursing , pathology
Several key factors bear on the interpretation of prevention trials and observational studies that inform prevention strategies. These factors include the underlying disease process and aspects of the intervention: sustainability of behavior change, the time course of the intervention within the disease process, dose and duration of exposure needed to effect risk reduction, durability of the impact of intervention, and methodological problems in implementing and interpreting randomized trials and observational studies to evaluate prevention strategies. The question asked through an intent-to-treat analysis of a randomized controlled trial (RCT) differs from that in the observational setting. Furthermore, the long duration necessary to conduct prevention trials and the resulting lack of adherence to therapy can bias results toward the null. A broader range of approaches to evaluate prevention interventions and programs with improved knowledge synthesis and translation to public health practice will speed our progress toward achieving public health and prevention of chronic diseases.