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Patient enrollment in medical trials: Selection bias in a randomized experiment

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  • Malani, Anup

Abstract

Self-selection can bias estimates of treatment effects from randomized experiments if one is interested in extrapolating results to the general population. This paper notes that there is an isomorphism between the Roy model for the sorting of workers into sectors and the decision of subjects to participate in randomized experiments. The main implication is that, as the probability of receiving active treatment rises, patients who are less optimistic about new treatment will begin to enroll and estimates of treatment effects will fall. This, in turn, implies that selection bias is positive. These findings are confirmed with data from trials of ulcer medications.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Econometrics.

Volume (Year): 144 (2008)
Issue (Month): 2 (June)
Pages: 341-351

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Handle: RePEc:eee:econom:v:144:y:2008:i:2:p:341-351

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Web page: http://www.elsevier.com/locate/jeconom

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  1. Tomas Philipson, 1999. "External Treatment Effects and Program Implementation Bias," Working Papers 9929, Harris School of Public Policy Studies, University of Chicago.
  2. Heckman, James J, 1996. "Randomization as an Instrumental Variable: Notes," The Review of Economics and Statistics, MIT Press, vol. 78(2), pages 336-41, May.
  3. James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
  4. Heckman, James J & Honore, Bo E, 1990. "The Empirical Content of the Roy Model," Econometrica, Econometric Society, vol. 58(5), pages 1121-49, September.
  5. Hadar, Josef & Russell, William R, 1969. "Rules for Ordering Uncertain Prospects," American Economic Review, American Economic Association, vol. 59(1), pages 25-34, March.
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Cited by:
  1. Sylvain Chassang & Gerard Padro i Miquel & Erik Snowberg, 2010. "Selective Trials: A Principal-Agent Approach to Randomized Controlled Experiments," NBER Working Papers 16343, National Bureau of Economic Research, Inc.
  2. Utteeyo Dasgupta & Lata Gangadharan & Pushkar Maitra & Subha Mani & Samyukta Subramanian, 2012. "Choosing to be Trained: Evidence from a Field Experiment," Development Research Unit Working Paper Series 43-12, Monash University, Department of Economics.
  3. Belot, Michele & James, J, 2014. "A New Perspective on the Issue of Selection Bias into Randomized Controlled Field Experiments," Department of Economics Working Papers 39843, University of Bath, Department of Economics.
  4. Anup Malani & Tomas J. Philipson, 2011. "Can Medical Progress be Sustained? Implications of the Link Between Development and Output Markets," NBER Working Papers 17011, National Bureau of Economic Research, Inc.

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