Allocation of treatments

The distinction can be made between horizontal and vertical equity. Horizontal equity is the equal treatment of equals individuals with the same needs should receive equivalent amounts of care or support, or individuals with the same personal means (for example, in relation to income or wealth) should bear equal burdens of funding. Vertical equity is the differential allocation of treatments or outcomes to individuals with different needs, or a differential burden of payment such as a progressive tax. Targeting services on needs is the most common example of the pursuit of greater equity, and it is therefore also legitimate to question the efficiency with which equity is pursued. 

Triage The sorting of and allocation of treatment to patients, particularly in warfare or disasters, according to a system of priorities according to the urgency of their need for care designed to maximize the numbers of survivors. 

Dynamic aibcation is an alternative procedure in which the allocation of treatment to a subject is influenced by the current balance of allocated treatments and, in a stratified trial, by the stratum to which the subject belongs and the balance within that stratum. Deterministic dynamic allocation procedures should be avoided and an appropriate element of randomisation should be incorporated for each treatment allocation. ... 

The allocation of treatments to the four blocks proceeds in the usual manner, and is set out with the yields obtained in Table 14.6. 

Table 14.10 will be found to satisfy the condition of both Tables 14.8 and 14.9, and accordingly is the correct allocation of treatments. The analysis of variance proceeds normally, all the interactions being confounded not being mentioned specifically in the table of analysis of variance but their Sums of Squares and Degrees of Freedom being lumped together under the description Blocks. ... 

Snowdon C, Garcia J, Elbourne D (1997). Making sense of randomisation response of parents of critically ill babies to random allocation of treatment in a clinical trial. Soc Sci Med 45 1337-1355. 

Clinical trial A formal study of a treatment conducted in patients with a specific disease indication. Such studies usually involve comparison with placebo or an alternative treatment and a randomisation process is used to determine the allocation of treatments. Ideally, they also involve blinding of patients and clinicians (i.e. they are double-blind ) to treatment allocations. Conducting a clinical trial involves intervening in patients treatments for research purposes and therefore informed consent from each patient and ethical committee approval are essential (see p. 31). 

Although stream standards are the most reaUstic in light of the use of the assimilative capacity of the receiving water, they are difficult to administer and control in an expanding industrial and urban area. The equitable allocation of poUutional loads for many industrial and municipal complexes also poses pohtical and economic difficulties. A stream standard based on minimum dissolved oxygen at low stream flow intuitively implies a minimum degree of treatment. One variation of stream standards is the specification of a maximum concentration of a poUutant (ie, the BOD) in the stream after mixing at a specified low flow condition. 

Random allocation of animals to treatment groups is a prerequisite of good experimental design. If not carried out, one can never be sure whether treatment-... 

The need for randomization applies not only to the allocation of the animals to the treatment, but also to anything that can materially affect the recorded response. The same random number that is used to apply animals to treatment group can be used to determine cage position, order of weighing, order of bleeding for clinical chemistry, order of sacrifice at terminations and so on. 

As far as possible, the study should be conducted under double-blind conditions. Sometimes, pharmacological effects, desired or undesired, tend to unblind the study but even in these circumstances the identity of treatment will be unknown to subjects and observers at the time of dosing and before onset of effects, thereby minimising bias. Specified persoimel, such as the pharmacist, bioanalyst and pharmacokineticist, may need to know the treatment allocation code... 

A trial is conducted in which a physician decides to allocate some patients to a new treatment, and other patients he treats with what until now has been his first choice of treatment. He monitors the changes in all the patients over time and at a predetermined time compares the results from the two groups of patients. A difference is found. In order to be confident that the observed difference is real, the physician needs to assume that the patients in the two groups are essentially identical in respect to all important factors that are important to the disease and its prognosis. Unfortunately, without randomisation we cannot be sure that such an assumption is valid. As we noted in Section 8.5.4.1 the strength of... 

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