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Trial Design: Pain Sections
Author Bio
Introduction
Placebo Effects
Single Dose Trials
Repeated Dose Trials
Explanatory Versus Pragmatic
Dose-Response
Currently selected section: Parallel Group Versus Crossover
Conclusion
 

 

Chapter 1: Clinical Trials of Pain Treatment: Parallel Group Versus Crossover Designs

 
        

Would the use of a crossover design be likely to offer advantages over a parallel group design in comparing a quickly-eliminated oral drug that blocks pain transmission in patients with diabetic neuropathy to a placebo?

You answered:

No.

INCORRECT

Many published trials show the success of crossover trials in chronic stable neuropathic pain conditions in which two or three treatments are each given for 3 – 6 weeks. Pain usually returns to levels approaching baseline within a week or two after treatment withdrawal. Our clinic’s experience has been that about 10% of the patients drop out during each 6-week treatment period. Even considering this, and the greater chance of change in the underlying disease over the longer treatment period, we have estimated that a crossover study offered us a level of statistical power that would have required five times the number of patients enrolled in a parallel group study.

 

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