Interrupted time series regression for the evaluation of public health interventions: a tutorial.


Bernal, JL; Cummins, S; Gasparrini, A; (2016) Interrupted time series regression for the evaluation of public health interventions: a tutorial. International journal of epidemiology, 46 (1). pp. 348-355. ISSN 0300-5771 DOI: https://doi.org/10.1093/ije/dyw098

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Abstract

: Interrupted time series (ITS) analysis is a valuable study design for evaluating the effectiveness of population-level health interventions that have been implemented at a clearly defined point in time. It is increasingly being used to evaluate the effectiveness of interventions ranging from clinical therapy to national public health legislation. Whereas the design shares many properties of regression-based approaches in other epidemiological studies, there are a range of unique features of time series data that require additional methodological considerations. In this tutorial we use a worked example to demonstrate a robust approach to ITS analysis using segmented regression. We begin by describing the design and considering when ITS is an appropriate design choice. We then discuss the essential, yet often omitted, step of proposing the impact model a priori. Subsequently, we demonstrate the approach to statistical analysis including the main segmented regression model. Finally we describe the main methodological issues associated with ITS analysis: over-dispersion of time series data, autocorrelation, adjusting for seasonal trends and controlling for time-varying confounders, and we also outline some of the more complex design adaptations that can be used to strengthen the basic ITS design.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: Centre for Statistical Methodology
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PubMed ID: 27283160
Web of Science ID: 402724100044
URI: http://researchonline.lshtm.ac.uk/id/eprint/2550793

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