Stepped-wedge cluster-randomised trials: level of evidence, feasibility and reporting

摘要

The stepped-wedge cluster-randomised trial is a form ofcluster-crossover trial with unidirectional crossover betweencontrol and intervention conditions. It has become a popularresearch design, particularly in effectiveness and implementationof science research over the past decade.1 The ascension of thestepped-wedge as a design of preference has been criticised insome quarters, yet praised in others.2,3 However, there is a need forresearchers and research users to better understand the intricaciesof this design so that they can appropriately design, appraise anduse information generated from trials using this approach. ThisResearch Note describes the stepped-wedge design, discusseswhether this design provides evidence on par with otherrandomised, controlled trial designs, and highlights some keyconsiderations for feasibility and reporting.