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Cascade diagrams for depicting complex interventions in randomised trials

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Hooper, R., Froud, Robert J., Bremner, Stephen A., Perera, R. and Eldridge, Sandra (2013) Cascade diagrams for depicting complex interventions in randomised trials. BMJ, Volume 347 . Article number f6681. doi:10.1136/bmj.f6681 ISSN 0959-535X.

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Official URL: http://dx.doi.org/10.1136/bmj.f6681

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Abstract

Many medical interventions—particularly non-pharmacological
ones—are complex, consisting of multiple interacting
components targeted at different organisational levels.1 2
Published descriptions of complex interventions often do not
contain enough detail to enable their replication.2-5 Reports of
behaviour change interventions should include descriptions of
setting, mode, intensity, and duration, and characteristics of the
participants.6 Graphical methods, such as that showing the
relative timing of assessments and intervention components,7
may improve clarity of reporting. However, these approaches
do not reveal the connections between the different “actors” in
a complex intervention.8 Different audiences may want different
things from a description of an intervention, but visualising
relationships between actors can clarify crucial features such
as the fidelity with which the intervention is passed down a
chain of actors
and possible routes of contamination between
treatment arms. Here we describe a new graphical approach—the
cascade diagram—that highlights these potential problems.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Medical statistics , Clinical trials -- Charts, diagrams, etc., Biometry
Journal or Publication Title: BMJ
Publisher: BMJ Publishing Group Ltd.
ISSN: 0959-535X
Official Date: 15 November 2013
Dates:
DateEvent
15 November 2013Published
Volume: Volume 347
Article Number: Article number f6681
DOI: 10.1136/bmj.f6681
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 28 December 2015
Date of first compliant Open Access: 28 December 2015

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