Open AccessAlternatives to the Randomized Controlled Trial
Author(s) -
Stephen G. West,
Naihua Duan,
Willo Pequegnat,
Paul Gaist,
Don C. Des Jarlais,
David R. Holtgrave,
José Szapocznik,
Martin Fishbein,
Bruce D. Rapkin,
Michael C. Clatts,
Patricia Dolan Mullen
Publication year - 2008
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2007.124446
Subject(s) - randomized controlled trial , observational study , randomized experiment , causal inference , research design , random assignment , psychology , medicine , econometrics , statistics , economics , mathematics , surgery , pathology
Public health researchers are addressing new research questions (e.g., effects of environmental tobacco smoke, Hurricane Katrina) for which the randomized controlled trial (RCT) may not be a feasible option. Drawing on the potential outcomes framework (Rubin Causal Model) and Campbellian perspectives, we consider alternative research designs that permit relatively strong causal inferences. In randomized encouragement designs, participants are randomly invited to participate in one of the treatment conditions, but are allowed to decide whether to receive treatment. In quantitative assignment designs, treatment is assigned on the basis of a quantitative measure (e.g., need, merit, risk). In observational studies, treatment assignment is unknown and presumed to be nonrandom. Major threats to the validity of each design and statistical strategies for mitigating those threats are presented.