Letter to the Editor
Comment in: https://www.jmir.org/2020/10/e24084
doi:10.2196/21505
Keywords
We read the article “Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial” by Chan et al [
] with great interest. The idea that face to face education is difficult and education via the internet or social networking systems is necessary is intriguing; this is an important perspective in the midst of the COVID-19 pandemic. In the article, the editor wrote, “readers are advised to carefully assess the validity of any potential explicit or implicit claims related to primary outcomes or effectiveness”; hence, we would like to discuss some perspectives.First, the primary outcome was measured using the differences in the scores of the pre- and postintervention knowledge assessments, which comprised the 25-item Dementia Knowledge Assessment Scale (DKAS) and a formative evaluation of 20 multiple-choice questions. However, the authors’ conclusion is focused on the outcome of improving participants’ knowledge concerning a single subscale in DKAS. This interpretation might be a spin that could warp the interpretation of results and mislead readers [
].Second, the article has issues with multiple testing. When tests are divided into subscales, some of them may have significant differences. To show a significant difference in the effect, corrections to the multiple tests are required [
].Finally, this study is a pre and post study; therefore, a paired t test should be used instead of a two-sample t test. The two-sample t test estimates the treatment effect using only the responses at follow-up, and it does not use any information at baseline, which may be useful for increasing efficiency if the baseline and follow-up outcomes are correlated [
].Conflicts of Interest
None declared.
References
- Chan WS, Leung AY. Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial. J Med Internet Res 2020 Jun 02;22(6):e16772 [FREE Full text] [CrossRef] [Medline]
- Boutron I, Dutton S, Ravaud P, Altman DG. Reporting and interpretation of randomized controlled trials with statistically nonsignificant results for primary outcomes. JAMA 2010 May 26;303(20):2058-2064. [CrossRef] [Medline]
- Li G, Taljaard M, Van den Heuvel ER, Levine MA, Cook DJ, Wells GA, et al. An introduction to multiplicity issues in clinical trials: the what, why, when and how. Int J Epidemiol 2017 Apr 01;46(2):746-755. [CrossRef] [Medline]
- Yang L, Tsiatis AA. Efficiency Study of Estimators for a Treatment Effect in a Pretest–Posttest Trial. The American Statistician 2001 Nov;55(4):314-321. [CrossRef]
Abbreviations
DKAS: Dementia Knowledge Assessment Scale |
Edited by T Derrick, G Eysenbach; submitted 30.06.20; peer-reviewed by WSY Chan; accepted 01.10.20; published 30.10.20
Copyright©Yusuke Saishoji, Akihiro Shiroshita, Yasushi Tsujimoto. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.10.2020.
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