Hello. Our team is very interested in adopting the staggered randomized or stepped wedge design, could you give us more practical tips?

No worries.

Thanks for the information.

If your evaluation uses a randomized design by lottery or by staggered rollout, it is critical to select practices at random. Picking a practice for the intervention group because it seemed to have the strongest physician commitment, or because it had better or worse patient outcomes, makes it difficult to disentangle the effects of the intervention from those of the practice’s existing performance or motivation. Similarly, in a staggered randomized design, be sure to randomize practices into rollout periods, avoiding the urge to start with practices that are more sophisticated or more eager to begin the intervention.