Orthogonal factorial designs for trials of therapist-delivered interventions: Randomising intervention-therapist combinations to patients
Fuente:
arXiv
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Preprint |
| Published: |
2026
|
| Subjects: | |
| Online Access: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1866914300253175808 |
|---|---|
| author | Walwyn, Rebecca EA Bailey, Rosemary A Singh, Arpan Corrigan, Neil Gilmour, Steven G |
| author_facet | Walwyn, Rebecca EA Bailey, Rosemary A Singh, Arpan Corrigan, Neil Gilmour, Steven G |
| contents | It is recognised that treatment-related clustering should be allowed for in the sample size and analyses of individually-randomised parallel-group trials that evaluate therapist-delivered interventions such as psychotherapy. Here, interventions are a treatment factor, but therapists are not. If the aim of a trial is to separate effects of therapists from those of interventions, we propose that interventions and therapists should be regarded as two potentially interacting treatment factors (one fixed, one random) with a factorial structure. We consider the specific design where each therapist delivers each intervention (crossed therapist-intervention design), and the resulting therapist-intervention combinations are randomised to patients. We adopt a classical Design of Experiments (DoE) approach to propose a family of orthogonal factorial designs and their associated data analyses, which allow for therapist learning and centre too. We set out the associated data analyses using ANOVA and regression and report the results of a small simulation study conducted to explore the performance of the proposed randomisation methods in estimating the intervention effect and its standard error, the between-therapist variance and the between-therapist variance in the intervention effect. We conclude that more purposeful trial design has the potential to lead to better evidence on a range of complex interventions and outline areas for further methodological research. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2601_16318 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | Orthogonal factorial designs for trials of therapist-delivered interventions: Randomising intervention-therapist combinations to patients Walwyn, Rebecca EA Bailey, Rosemary A Singh, Arpan Corrigan, Neil Gilmour, Steven G Methodology It is recognised that treatment-related clustering should be allowed for in the sample size and analyses of individually-randomised parallel-group trials that evaluate therapist-delivered interventions such as psychotherapy. Here, interventions are a treatment factor, but therapists are not. If the aim of a trial is to separate effects of therapists from those of interventions, we propose that interventions and therapists should be regarded as two potentially interacting treatment factors (one fixed, one random) with a factorial structure. We consider the specific design where each therapist delivers each intervention (crossed therapist-intervention design), and the resulting therapist-intervention combinations are randomised to patients. We adopt a classical Design of Experiments (DoE) approach to propose a family of orthogonal factorial designs and their associated data analyses, which allow for therapist learning and centre too. We set out the associated data analyses using ANOVA and regression and report the results of a small simulation study conducted to explore the performance of the proposed randomisation methods in estimating the intervention effect and its standard error, the between-therapist variance and the between-therapist variance in the intervention effect. We conclude that more purposeful trial design has the potential to lead to better evidence on a range of complex interventions and outline areas for further methodological research. |
| title | Orthogonal factorial designs for trials of therapist-delivered interventions: Randomising intervention-therapist combinations to patients |
| topic | Methodology |
| url | https://arxiv.org/abs/2601.16318 |