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Generalizability of the findings from a randomized controlled trial of a web‐based substance use disorder intervention
Author(s) -
Susukida Ryoko,
Crum Rosa M.,
Stuart Elizabeth A.,
Mojtabai Ramin
Publication year - 2018
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/ajad.12714
Subject(s) - generalizability theory , randomized controlled trial , abstinence , population , medicine , psychological intervention , clinical psychology , representativeness heuristic , psychology , psychiatry , social psychology , developmental psychology , environmental health
Background and Objectives There is growing concern regarding the generalizability of findings from randomized controlled trials (RCTs) of interventions for substance use disorders (SUDs). This study used a selection model approach to assess and improve the generalizability of an evaluation for a web‐based SUD intervention by making the trial sample resemble the target population. Methods The sample of the web‐based SUD intervention (Therapeutic Education System vs. Treatment‐as‐usual; n = 507) was compared with the target population of SUD treatment‐seeking individuals from the Treatment Episodes Data Set‐Admissions (TEDS‐A). Using weights based on the probabilities of RCT participation, we computed weighted treatment effects on retention and abstinence. Results Substantial differences between the RCT sample and the target population was demonstrated in significant difference in the mean propensity scores (1.62 standard deviations at p < .001). The population effect on abstinence (12 weeks and 6 months) was statistically insignificant after weighting the data with the generalizability weight. Discussions and Conclusions Generalizability of the findings from the RCT could be limited when the RCT sample does not well represent the target population. Scientific Significance Application of generalizability weights can be a potentially useful tool to improve generalizability of RCT findings. (Am J Addict 2018;27:231–237)