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Health Services Research & Development

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QUERI Implementation Research

Alternatives to the Randomized Controlled Trial in Implementation Science


by Alex Young, MD, MSHS
Seminar date: 2/9/2012

Description: Implementation studies employing Randomized Controlled Trial designs are often faulted for prioritizing internal over external validity, and for placing excessive restrictions on sampling, intervention design and delivery, and intervention support activities. Although results from such studies can offer high-quality evidence of intervention impacts, the conditions under which the interventions are delivered are often non-representative, limiting the applicability and value of study findings. And, when sample sizes are small, randomization does not assure that unmeasured characteristics are similar in intervention and control groups. This talk presents alternative designs for evaluating interventions under routine, real-world conditions, and discusses key tradeoffs and features of alternative research approaches.

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