ArticleBiostatistics (Oxford, England)2023
Two-Stage TMLE to reduce bias and improve efficiency in cluster randomized trials.
Article in Biostatistics (Oxford, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed.
- Community-Wide Universal HIV Test and Treat Intervention Reduces Tuberculosis Transmission in Rural Uganda: A Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- A community-based dynamic choice model for HIV prevention improves PrEP and PEP coverage in rural Uganda and Kenya: a cluster randomized trial.Journal of the International AIDS Society · 2023Trial
- A multilevel health system intervention for virological suppression in adolescents and young adults living with HIV in rural Kenya and Uganda (SEARCH-Youth): a cluster randomised trial.The lancet. HIV · 2023Trial
- COADVISE: covariate adjustment with variable selection in randomized controlled trials.Journal of the Royal Statistical Society. Series A, (Statistics in Society) · 2026Article
- A Causal Framework for Evaluating the Total Effect of Strategies Aiming to Expand Screening and to Improve Outcomes.Statistics in medicine · 2026Article
- Machine learning to optimize precision in the analysis of randomized trials: A journey in pre-specified, yet data-adaptive learning.Clinical trials (London, England) · 2026Article
- Model-robust standardization in stepped wedge cluster randomized trials.Journal of the Royal Statistical Society. Series A, (Statistics in Society) · 2026Article
- Estimands and Doubly Robust Estimation for Cluster-Randomized Trials With Survival Outcomes.Statistics in medicine · 2026Article
- On the mixed-model analysis of covariance in cluster-randomized trials.Statistical science : a review journal of the Institute of Mathematical Statistics · 2026Article
- Handling incomplete outcomes and covariates in cluster-randomized trials: doubly robust estimation, efficiency considerations, and sensitivity analysis.Biometrics · 2026Article
- Recoverability of causal effects under presence of missing data: a longitudinal case study.Biostatistics (Oxford, England) · 2025Article
- Covariate adjustment in cluster randomised trials: a practical guide.BMJ (Clinical research ed.) · 2025Article
- Causal inference in randomized trials with partial clustering.Clinical trials (London, England) · 2025Article
- Handling Missing Outcome Data in Cluster Randomized Trials With Both Individual- and Cluster-Level Dropout.Statistics in medicine · 2025Article
- The Effect of a Life-Stage Based Intervention on Depression in Youth Living with HIV in Kenya and Uganda: Results from the SEARCH-Youth Trial.Tropical medicine and infectious disease · 2025Article
- Association between the age-adjusted Charlson Comorbidity Index and complications after kidney transplantation: a retrospective observational cohort study.BMC nephrology · 2024Observational
- Estimating marginal treatment effect in cluster randomized trials with multi-level missing outcomes.Biometrics · 2024Article
- Demystifying estimands in cluster-randomised trials.Statistical methods in medical research · 2024Article
- Blurring cluster randomized trials and observational studies: Two-Stage TMLE for subsampling, missingness, and few independent units.Biostatistics (Oxford, England) · 2024Article
- Adaptive selection of the optimal strategy to improve precision and power in randomized trials.Biometrics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
Cluster randomized trials (CRTs) randomly assign an intervention to groups of individuals (e.g., clinics or communities) and measure outcomes on individuals in those groups. While offering many advantages, this experimental design introduces challenges that are only partially addressed by existing analytic approaches. First, outcomes are often missing for some individuals within clusters. Failing to appropriately adjust for differential outcome measurement can result in biased estimates and inference. Second, CRTs often randomize limited numbers of clusters, resulting in chance imbalances on baseline outcome predictors between arms. Failing to adaptively adjust for these imbalances and other predictive covariates can result in efficiency losses. To address these methodological gaps, we propose and evaluate a novel two-stage targeted minimum loss-based estimator to adjust for baseline covariates in a manner that optimizes precision, after controlling for baseline and postbaseline causes of missing outcomes. Finite sample simulations illustrate that our approach can nearly eliminate bias due to differential outcome measurement, while existing CRT estimators yield misleading results and inferences. Application to real data from the SEARCH community randomized trial demonstrates the gains in efficiency afforded through adaptive adjustment for baseline covariates, after controlling for missingness on individual-level outcomes.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.