Transporting Subgroup Analyses of Randomized Controlled Trials for Planning Implementation of New Interventions.
Subgroup analyses of randomized controlled trials guide resource allocation and implementation of new interventions by identifying groups of individuals who are likely to benefit most from the intervention. Unfortunately, trial populations are rarely representative of the target populations of public health or clinical interest. Unless the relevant differences between trial and target populations are accounted for, subgroup results from trials might not reflect which groups in the target population will benefit most from the intervention. Transportability provides a rigorous framework for applying results derived in potentially highly selected study populations to external target populations. The method requires that researchers measure and adjust for all variables that 1) modify the effect of interest and 2) differ between the target and trial populations. To date, applications of transportability have focused on the external validity of overall study results and understanding within-trial heterogeneity; however, this approach has not yet been used for subgroup analyses of trials. Through an example from the Iniciativa Profilaxis Pre-Exposición (iPrEx) study (multiple countries, 2007-2010) of preexposure prophylaxis for human immunodeficiency virus, we illustrate how transporting subgroup analyses can produce target-specific subgroup effect estimates and numbers needed to treat. This approach could lead to more tailored and accurate guidance for resource allocation and cost-effectiveness analyses.
['Mehrotra|Megha L|ML|', 'Westreich|Daniel|D|', 'Glymour|M Maria|MM|', 'Geng|Elvin|E|', 'Glidden|David V|DV|']
D000328:Adult D003362:Cost-Benefit Analysis D003627:Data Interpretation, Statistical D015658:HIV Infections D015276:Health Care Rationing D018451:Homosexuality, Male D006801:Humans D008297:Male D065129:Pre-Exposure Prophylaxis D016032:Randomized Controlled Trials as Topic D015203:Reproducibility of Results D012107:Research Design D012959:Socioeconomic Factors
transportability subgroup analyses implementation external validity number needed to treat target-specific subgroup analyses