Cluster randomized controlled trial analysis at the cluster level: The clan command

Thompson, Jennifer A.; Leurent, Baptiste; Nash, Stephen; Moulton, Lawrence H.; Hayes, Richard J.

doi:10.1177/1536867x231196294

Cited by 8 publications

(2 citation statements)

References 17 publications

(32 reference statements)

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“…All analyses were performed using a clustered-level analysis approach instead of an individual-level analysis due to the small number of clusters included [38,39]. The analysis was performed using a two-stage approach as outlined by Hayes et al [39,40], to adjust for both the cluster-level and individual-level covariates. In the first stage, we used a logistic regression model for binary outcomes and linear regression model for continuous outcomes adjusting for covariates and ignoring clustering and trial arm.…”

Section: Methodsmentioning

confidence: 99%

Quality of care when using a digital clinical decision support algorithm to manage sick children at primary care health facilities in Tanzania: a cross-sectional cluster randomized controlled trial (DYNAMIC study)

Tan,

Kavishe,

Kulinkina

et al. 2024

Preprint

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Digital clinical decision support tools have contributed to improved quality of care at primary care level health facilities. However, data from real-world randomized trials are lacking. We conducted a cluster randomized, open-label trial in Tanzania evaluating the use of a digital clinical decision support algorithm (CDSA), enhanced by point-of-care tests, training and mentorship, compared with usual care, among sick children 2 to 59 months old presenting to primary care facilities for an acute illness in Tanzania (ClinicalTrials.govNCT05144763). The primary outcome was the mean proportion of 14 major Integrated Management of Childhood Illness (IMCI) symptoms and signs assessed by clinicians. Secondary outcomes included antibiotic prescription, counselling provided, and the appropriateness of antimalarial and antibiotic prescriptions. A total of 450 consultations were observed in 9 intervention and 9 control health facilities. The mean proportion of major symptoms and signs assessed in intervention health facilities was 46.4% (range 7.7% to 91.7%) compared to 26.3% (range 0% to 66.7%) in control health facilities, an adjusted difference of 15.1% (95% confidence interval [CI] 4.8% to 25.4%). Only weight, height, and pallor were assessed more often when using the digital CDSA than in controls. Observed antibiotic prescription was 37.3% in intervention facilities, and 76.4% in control facilities (adjusted risk ratio 0.5; 95% CI 0.4 to 0.7; p<0.001). Appropriate antibiotic prescription was 81.9% in intervention facilities and 51.4% in control facilities (adjusted risk ratio 1.5; 95% CI 1.2 to 1.8; p=0.003). The implementation of a digital CDSA improved only slightly the mean proportion of IMCI symptoms and signs assessed in consultations with sick children, and most symptoms and signs were assessed infrequently. Nonetheless, antibiotics were prescribed less often, and more appropriately Innovative approaches to overcome barriers related to clinicians’ motivation and work environment are needed.

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Section: Methodsmentioning

confidence: 99%

Quality of care when using a digital clinical decision support algorithm to manage sick children at primary care health facilities in Tanzania: a cross-sectional cluster randomized controlled trial (DYNAMIC study)

Tan,

Kavishe,

Kulinkina

et al. 2024

Preprint

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“…Clustering is a data mining algorithm that divides a dataset into different classes or clusters based on specific criteria, maximizing the similarity among data objects within the same cluster and maximizing the dissimilarity between data objects in different clusters [23]. The goal is to cluster similar data together and separate different data points as much as possible.…”

Section: The Coordinate Grid Methodsmentioning

confidence: 99%

A Novel Optimization Method for the Drilling Process in Panel Furniture Production

Wang,

Xiong

2024

Preprint

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The panel furniture industry is experiencing rapid development, with a growing focus on intelligent manufacturing and efficient production. However, in the process of upgrading the drilling process for panel furniture towards intelligentization, still lacks standard optimization methods. To address this issue, we conducted an analysis of the cabinet structure in panel furniture and propose a novel approach that utilizes matrices and sets to represent panel and drilling information, enabling efficient data analysis and subsequent optimization. Moreover, we introduce a comprehensive optimization method comprising the COING (a hierarchical clustering analysis method adapted for panel furniture based on the STING grid method) and AR (Association Rule) techniques, uncovering potential associations and relationships within datasets. To validate the efficacy of the proposed method, we implemented it in the production workshop of Company W. Experimental results demonstrate a 14.01% reduction in drilling frequency and a 3.869% improvement in drilling efficiency compared to traditional design methods. Our findings emphasize the practical significance of the proposed standard drilling optimization method in the panel furniture industry, effectively enhancing drilling efficiency and promoting the transition to intelligent manufacturing.

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Treatment adherence and clinical outcomes amongst in people with drug-susceptible tuberculosis using medication monitor and differentiated care approach compared with standard of care in South Africa: a cluster randomized trial

Charalambous,

Maraba,

Jennings

et al. 2024

eClinicalMedicine

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Cluster randomized controlled trial analysis at the cluster level: The clan command

Cited by 8 publications

References 17 publications

Quality of care when using a digital clinical decision support algorithm to manage sick children at primary care health facilities in Tanzania: a cross-sectional cluster randomized controlled trial (DYNAMIC study)

Quality of care when using a digital clinical decision support algorithm to manage sick children at primary care health facilities in Tanzania: a cross-sectional cluster randomized controlled trial (DYNAMIC study)

A Novel Optimization Method for the Drilling Process in Panel Furniture Production

Treatment adherence and clinical outcomes amongst in people with drug-susceptible tuberculosis using medication monitor and differentiated care approach compared with standard of care in South Africa: a cluster randomized trial

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