Advanced Methods for Primary Care Research: The Stepped Wedge Design

February 27, 2015 01:30 PM to 03:00 PM EST
Miriam Dickinson, PhD, University of Colorado; Gillian Bartlett-Esquilant, PhD, McGill University; Bethany Kwan, PhD, MSPH, University of Colorado and CaReNet PBRN; and Christopher Meaney, MSc, University of Toronto

The AHRQ’s Practice-Based Research Network Resource Center hosted a webinar on Friday, February 27th from 1:30pm-3:00pm EST. This presentation, based on a NAPCRG 2014 workshop presentation, outlined key features of the stepped wedge design; discussed issues and challenges around implementing stepped wedge designs in primary care based studies; and offered creative applications of methods and creative solutions to these unique challenges.

This Live series activity, AHRQ Practice-Based Research Network Resource Center National Webinars, from 09/10/2014 - 09/10/2015, has been reviewed and is acceptable for credit by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This webinar has been approved for 1.25 elective CME credit(s).

Moderator: Rebecca Roper, MS, MPH, Director, Practice-Based Research Network Initiative, Agency for Healthcare Research and Quality

Critical Reference Material: 

1.            Brown CA, Lilford RJ. The stepped wedge trial design: a systematic review. BMC Med Res Methodol.


2.            Dainty KN, Scales DC, Brooks SC, et al. A knowledge translation collaborative to improve the use of

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4.            Haines T, Hemming K, Girling A, Hill A-M, Bulsara M, Deeks J. Where should stepped-wedge designs

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8.            Kitson AL, Schultz TJ, Long L, et al. The prevention and reduction of weight loss in an acute tertiary care setting:

protocol for a pragmatic stepped wedge randomised cluster trial (the PRoWL project). BMC Health Services Research. 2013;13:299.

9.            Kotz D, Spigt M, Arts IC, Crutzen R, Viechtbauer W. Researchers should convince policy makers to

perform a classic cluster randomized controlled trial instead of a stepped wedge design when an intervention is rolled out. J Clin Epidemiol. Dec 2012;65(12):1255-1256.

10.          Kotz D, Spigt M, Arts IC, Crutzen R, Viechtbauer W. Use of the stepped wedge design cannot be

recommended: a critical appraisal and comparison with the classic cluster randomized controlled trial design. J Clin Epidemiol. Dec 2012;65(12):1249-1252.

11.          Mdege ND, Man MS, Taylor Nee Brown CA, Torgerson DJ. Systematic review of stepped wedge cluster

randomized trials shows that design is particularly used to evaluate interventions during routine implementation. J Clin Epidemiol. Sep 2011;64(9):936-948.

12.          Mdege ND, Man MS, Taylor nee Brown CA, Torgerson DJ. There are some circumstances where the

stepped-wedge cluster randomized trial is preferable to the alternative: no randomized trial at all. Response to the commentary by Kotz and colleagues. J Clin Epidemiol. Dec 2012;65(12):1253-1254.

13.          Mhurchu CN, Gorton D, Turley M, et al. Effects of a free school breakfast programme on children's

attendance, academic achievement and short-term hunger: results from a stepped-wedge, cluster randomised controlled trial. J Epidemiol Community Health. Mar 2013;67(3):257-264.

14.          Morrison LJ, Brooks SC, Dainty KN, et al. Improving Use of Targeted Temperature Management After Out-of-

Hospital Cardiac Arrest: A Stepped Wedge Cluster Randomized Controlled Trial. Critical Care Medicine. 9000;Publish Ahead of Print.

15.          van den Broek IV, van Bergen JE, Brouwers EE, et al. Effectiveness of yearly, register based screening for

chlamydia in the Netherlands: controlled trial with randomised stepped wedge implementation. Bmj. 2012;345:e4316.

16.          Woertman W, de Hoop E, Moerbeek M, Zuidema SU, Gerritsen DL, Teerenstra S. Stepped wedge designs

could reduce the required sample size in cluster randomized trials. J Clin Epidemiol. Jul 2013;66(7):752-758.

Event Materials:

Last Modified: May 2015