Centre-by-treatment interaction: What is the issue?



Anders Källen
Astra Draco, Lund


Abstract

When analyzing multicenter studies, one of the issues is how to handle the treatment-by-center interaction. This is an issue regardless of whether the interaction is statistically significant or not. If it is not statistically significant, should we analyze without the interaction term in the model or should it be included? If it is statistically significant, what, if any, conclusions can we draw from the study?

It will be argued from a clinical perspective that the center-by-treatment interaction is a non-issue and that the statistical analysis should reflect this. A mode of analysis of multicenter studies is proposed that focuses on the units studied, patients, and still acknowledges the statistician's which to adjust for centers and their interaction with treatment. The analysis is not conditioned on the outcome of the interaction test.