Intention to treat analysis

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Intention to treat analysis

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In epidemiology, an intention to treat (ITT) analysis is an analysis based on the initial treatment intent, not on the treatment eventually administered. It is based on the assumption that, as in real life, sometimes patients do not all receive optimal treatment, even though that was the initial intention. For the purposes of analysis, the reasons why the patient did not receive the treatment are ignored.

Rationale

Intention to treat analyses are done to avoid the effects of crossover and drop-out, which may break the randomization to the treatment groups in a study. Intention to treat analysis provides information about the potential effects of treatment policy rather than on the potential effects of specific treatment.

In contrast, efficacy subset analysis selects the subset of the patients who received the treatment of interest--regardless of initial randomization--and who have not dropped out for any reason. This approach can :

  • introduce biases to the statistical analysis
  • inflate the type I error; this effect is greater the larger the trial[1].

Full application of intention to treat can only be performed where there is complete outcome data for all randomised subjects.

Although intention to treat is widely cited in published trials, it is often incorrectly described and its application may be flawed.

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Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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