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A cost effectiveness of the PACE trial

Bob

Senior Member
Messages
16,455
Location
England (south coast)
An example of poor methodology is the cost for SMC given for every group. Seeing as SMC was the main control condition, and was a controllable variable, then the cost for SMC should be identical for each participant for each group, or roughly identical across groups. But, oh what a surprise, in table 3, the SMC-group costs for SMC are £358 whereas the other groups are £213-£230, which is as low as 59% of the costs for the SMC group. This is a large cost discrepancy, and a bias, that the investigators have consciously introduced into the study.
 
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user9876

Senior Member
Messages
4,556
An example of poor methodology is the cost for SMC given for every group. Seeing as SMC was the main control condition, and was a controllable variable, then the cost for SMC should be identical for each participant for each group, or roughly identical across groups. But, oh what a surprise, in table 3, the SMC-group costs for SMC are £358 whereas the other groups are £213-£230, which is as low as 59% of the costs for the SMC group. This is a large cost discrepancy, and a bias, that the investigators have consciously introduced into the study.

One of the big issues with studies like this is it gets hard to control for every possible variable and some that never occurred to the trail designers. It is one of the reasons I think that reliance on RCTs as a blackbox methodology is wrong and not scientific. The idea tried to borrow from science but in a way that cannot be adequately done.
 
Messages
13,774
An example of poor methodology is the cost for SMC given for every group. Seeing as SMC was the main control condition, and was a controllable variable, then the cost for SMC should be identical for each participant for each group, or roughly identical across groups. But, oh what a surprise, in table 3, the SMC-group costs for SMC are £358 whereas the other groups are £213-£230, which is as low as 59% of the costs for the SMC group. This is a large cost discrepancy, and a bias, that the investigators have consciously introduced into the study.

Didn't the SMC only group attend (on average) an extra session of SMC?
 
Messages
13,774
Yes, the SMC-group received more sessions of SMC. My point is that they should have received the same amount of SMC seeing as it was a control group. This was a variable entirely controlled by the trial investigators.

I think that all patients had the option of a number of sessions of SMC, but different patients chose to attend different numbers of sessions. It's a bit odd, but given the other problems with the design, I don't know if they had an ideal solution.