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Intent to treat analysis

An intent-to-treat analysis simply measures change from the first measurement to the last measurement in the treatment episode, regardless of when the measurement occurred; as opposed to an as-treated analysis which selects cases based on a predetermined criteria for completion and compliance with the study protocol.

The intent-to-treat analysis is most appropriate for effectiveness studies, which seek to evaluate treatment outcomes in real world settings. The intent-to-treat method rewards clinicians who are expert at keeping patients engaged in treatment until optimal benefit is realized. This method also tends to reward clinicians who administer the outcome measure frequent intervals, as these clinicians are best able to monitor patient improvement and identify patients at risk for premature termination and consequently poor outcome. Frequent measurement also assures that the pre-post change score will reflect all of the change during the treatment episode.

See EfficacyAndEffectiveness for further discussion of the distinction between efficacy and effectiveness of studies.

For further reading on this topic, see Fraser et al, 2005: Efficacy versus Intent-to-treat Analyses: How Much Intervention Is Necessary for a “Desirable” Outcome?

-- JebBrown - 07 Jan 2007
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