Intention-to-treat concept: A review.

Sandeep K Gupta
Author Information
  1. Sandeep K Gupta: Clinical Pharmacologist, Gurgaon, India.

Abstract

Randomized controlled trials often suffer from two major complications, i.e., noncompliance and missing outcomes. One potential solution to this problem is a statistical concept called intention-to-treat (ITT) analysis. ITT analysis includes every subject who is randomized according to randomized treatment assignment. It ignores noncompliance, protocol deviations, withdrawal, and anything that happens after randomization. ITT analysis maintains prognostic balance generated from the original random treatment allocation. In ITT analysis, estimate of treatment effect is generally conservative. A better application of the ITT approach is possible if complete outcome data are available for all randomized subjects. Per-protocol population is defined as a subset of the ITT population who completed the study without any major protocol violations.

Keywords

References

  1. Br J Clin Pharmacol. 2002 Aug;54(2):203-11 [PMID: 12207643]
  2. Br J Cancer. 1993 Oct;68(4):647-50 [PMID: 8398686]
  3. Med J Aust. 2003 Oct 20;179(8):438-40 [PMID: 14558871]
  4. PM R. 2010 Mar;2(3):209-13 [PMID: 20359686]
  5. CMAJ. 2001 Nov 13;165(10):1339-41 [PMID: 11760981]
  6. Evid Based Ment Health. 2001 Aug;4(3):70-1 [PMID: 12004740]
  7. Stat Med. 2003 Jan 30;22(2):169-86 [PMID: 12520555]
  8. Rev Port Cardiol. 2002 Oct;21(10):1191-8 [PMID: 12522981]
  9. HIV Clin Trials. 2000 Sep-Oct;1(2):31-8 [PMID: 11590497]
  10. J Bone Joint Surg Am. 2006 Sep;88(9):2097-9 [PMID: 16951128]
  11. Clin Trials. 2007;4(3):286-91 [PMID: 17715258]
  12. Am J Health Syst Pharm. 2010 Aug 15;67(16):1337-43 [PMID: 20689122]
  13. J Clin Oncol. 2006 Mar 1;24(7):1026-8 [PMID: 16505420]
  14. Psychiatr Ann. 2008 Dec;38(12):772-783 [PMID: 20717484]
  15. Ann Intern Med. 2001 Apr 17;134(8):657-62 [PMID: 11304106]
  16. Nutr Metab (Lond). 2009 Jan 09;6:1 [PMID: 19134186]
  17. J Fam Pract. 2002 Nov;51(11):969-71 [PMID: 12485553]
  18. BMJ. 1999 Sep 11;319(7211):670-4 [PMID: 10480822]
  19. JAMA. 2006 Mar 8;295(10):1152-60 [PMID: 16522836]
  20. BMJ. 2010 Jun 14;340:c2697 [PMID: 20547685]
  21. Stat Med. 2005 Jan 15;24(1):1-10 [PMID: 15532089]
  22. BMJ. 2002 Sep 21;325(7365):652-4 [PMID: 12242181]
  23. JAMA. 2006 Mar 8;295(10):1147-51 [PMID: 16522835]
  24. J Dent Res. 2004;83 Spec No C:C113-5 [PMID: 15286135]
  25. Br J Clin Pharmacol. 2001 Sep;52(3):223-8 [PMID: 11560553]
  26. J Clin Epidemiol. 2007 Jul;60(7):663-9 [PMID: 17573981]
  27. Stat Med. 2006 Apr 15;25(7):1169-81 [PMID: 16397861]
  28. Int J Epidemiol. 1992 Oct;21(5):837-41 [PMID: 1468842]

Word Cloud

Created with Highcharts 10.0.0ITTanalysisrandomizedtreatmentcontrolledtrialsmajornoncomplianceprotocolpopulationIntention-to-treatRandomizedoftensuffertwocomplicationsiemissingoutcomesOnepotentialsolutionproblemstatisticalconceptcalledintention-to-treatincludeseverysubjectaccordingassignmentignoresdeviationswithdrawalanythinghappensrandomizationmaintainsprognosticbalancegeneratedoriginalrandomallocationestimateeffectgenerallyconservativebetterapplicationapproachpossiblecompleteoutcomedataavailablesubjectsPer-protocoldefinedsubsetcompletedstudywithoutviolationsconcept:reviewper-protocol

Similar Articles

Cited By