University of Groningen Evaluation and analysis of stepped wedge designs Zhan, Zhuozhao

Zhan, Zhuozhao

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Publication date: 2018

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Zhan, Z. (2018). Evaluation and analysis of stepped wedge designs: Application to colorectal cancer follow-up. Rijksuniversiteit Groningen.

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E

VALUATION AND ANALYSIS OF

STEPPED WEDGE DESIGNS

A

-

LA_{TEX template: Based on the L}A_{TEX PhD thesis template of Technical University Delft}

Financial support for the publishing of this thesis was kindly provided by University of Groningen, University Medical Center Groningen, and Research Institude SHARE. An electronic version of this dissertation is available at

E

VALUATION AND ANALYSIS OF

STEPPED WEDGE DESIGNS

A

-

Proefschrift

ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen

op gezag van de

rector magnificus prof. dr. E. Sterken, en volgens besluit van het College voor Promoties.

De openbare verdediging zal plaatsvinden op maandag 12 februari 2018 om 14.30 uur

door

Zhuozhao Zhan

geboren op 10 november 1988 te Zhejiang, China

Paranimfen

Anne Looijmans Xuan Anh Phí Bronislaw Abramiuc

C

ONTENTS

1 Introduction 1

1.1 Chapter outline . . . 2

1.2 Stepped wedge design . . . 3

1.3 Sample size calculation. . . 6

1.4 Stepped wedge design in cancer epidemiology . . . 7

1.5 The CEA-Watch trial . . . 8

1.6 Stepped wedge design for CEA-Watch . . . 10

1.7 Thesis aims and outline . . . 12

References . . . 13

2 Strength and weakness 17 2.1 Introduction . . . 19 2.2 Methods/design . . . 20 2.3 Results . . . 27 2.4 Discussion . . . 33 References . . . 35 3 Statistical analysis 39 3.1 Introduction . . . 41 3.2 Methods. . . 42 3.3 Simulation . . . 48 3.4 Results . . . 50 3.5 Discussion . . . 56 References . . . 57

4 CEA-Watch: Primary outcomes 61 4.1 Introduction . . . 63

4.2 Materials and methods . . . 64

4.3 Results . . . 69

4.4 Discussion . . . 75

References . . . 78

6 CEA-Watch: Psychological evaluation 105

6.1 Introduction . . . 107

6.2 Materials and Methods . . . 108

6.3 Results . . . 117 6.4 Discussion . . . 121 References . . . 124 Supplementary material . . . 126 7 Discussion 129 7.1 Summary . . . 130 7.2 Practical implications. . . 134

7.3 Generalization and future studies . . . 139

References . . . 141

Nederlandse samenvatting 145 Acknowledgements 153 Curriculum Vitæ 157