Generalization of treatment gains

Gregory, K. M., Kehle, T. J., McLoughlin, C. S. (1997). Generalization and maintenance of treatment gains using self-management procedures with behaviorally disordered adolescents. Psychological Reports, 80, 683-690. 

The effects of stimulant medication generally cease upon discontinuation of the treatment. One double-blind study, however, did not find this to be necessarily true for DEX (Gillberg et ah, 1997). Many patients favor a period off the medication, a drug holiday, to deal with the partial suppression of weight gain, worries about long-term effects, or to assess the need for staying on medication. This type of trial is best done when the child is not scheduled for important school tests or social activities (e.g., summer camp). 

It should be noted that these are not the only acceptable methods applicable to multiple comparisons from an ANOVA. In each individual case, the choice among possible approaches is largely dependent on the study design. For example, Dunnett s test can be used when the only comparisons of interest are each test treatment versus a control (for example, in a placebo-controlled, dose-ranging study). Like Tukey s test, Dunnett s method is more powerful than Bonferroni s. In general, other methods gain power compared with Bonferroni s method by... 

Furthermore, where there are true differences between patients, a more efficient way to gain information about the effect of a treatment with the object simply of establishing that it works would be to run an AB/BA cross-over. There is more information to be gained about the average effects of treatment under such circumstances by adding more patients rather than more periods. Hence in phase II there is generally little point in running n-of-1 trials. 

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