Intention-to-treat. What is the question?
2009

Understanding Intention-to-Treat Analysis in Trials

Commentary Evidence: moderate

Author Information

Author(s): Richard D Feinman

Primary Institution: Department of Biochemistry, SUNY Downstate Medical Center, Brooklyn, NY, USA

Hypothesis

Does Intention-to-Treat analysis accurately reflect treatment efficacy in randomized controlled trials?

Conclusion

Intention-to-Treat analysis can mislead conclusions about treatment efficacy by conflating adherence with treatment outcomes.

Supporting Evidence

  • Intention-to-Treat analysis can obscure the true efficacy of treatments by mixing results from compliant and non-compliant subjects.
  • Misinterpretations of ITT results can lead to incorrect health recommendations.
  • Two examples illustrate how ITT can misrepresent the effectiveness of vitamin E and diet comparisons.

Takeaway

When researchers look at how well a treatment works, they sometimes include people who didn't follow the rules of the study, which can make the results confusing.

Methodology

The commentary discusses the implications of using Intention-to-Treat analysis in randomized controlled trials, highlighting its potential misuse.

Potential Biases

Including non-compliant subjects in analyses can introduce misleading bias regarding treatment efficacy.

Limitations

The commentary does not provide empirical data but rather critiques existing studies and methodologies.

Statistical Information

P-Value

0.003

Confidence Interval

95% CI, 0.64–0.92

Statistical Significance

p=0.003

Digital Object Identifier (DOI)

10.1186/1743-7075-6-1

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