A sensitivity analysis of the Children’s Treatment Network trial: a randomized controlled trial of integrated services versus usual care for children with special health care needs

Figures & data

Figure 1 Components of the Children’s Treatment Network versus usual care.

Abbreviations: CTN, Children’s Treatment Network; RCT, randomized controlled trial; REB, research ethics board.

Figure 2 Summary of different analytical approaches.

Abbreviation: PS, propensity score.

Figure 3 Flow of children in the Children’s Treatment Network trial.

Abbreviation: CTN, Children’s Treatment Network.

Table 1 Baseline characteristics

Baseline variable	Intervention (n = 229)	Control (n = 216)	P-value
Child’s age, mean (SD)	7.8 (4.3)	8.1 (4.6)	0.60
Child’s sex, frequency (%)
Male	148 (64.6%)	149 (69.0%)	0.33
Female	81 (35.4%)	67 (31.0%)
Child’s admission diagnostic, frequency (%)
Mental and developmental disorders	106 (46.3%)	95 (44.0%)	0.81
Diseases of the nervous system	53 (23.1%)	51 (23.6%)
Congenital abnormalities	39 (17.0%)	34 (15.7%)
Other disease	31 (13.5%)	36 (16.7%)
Child’s psychosocial score, mean (SD)	59.0 (18.6)	59.2 (18.6)	0.85
Parent’s age, mean (SD)	40.5 (7.6)	40.4 (7.7)	0.95
Marital status, frequency (%)
Married including common-law	190 (83.0%)	187 (86.6%)	0.29
Other	39 (17.0%)	29 (13.4%)
Parent’s education, frequency (%)
Secondary	83 (36.4%)	78 (36.1%)	0.95
Post-secondary	145 (63.6%)	138 (63.9%)
Family annual income, frequency (%)
<$30,000	32 (14.0%)	32 (14.9%)	0.96
$30,000–$90,000	121 (53.1%)	114 (53.0%)
>$90,000	75 (32.9%)	69 (32.1%)
Parent’s Kessler distress score, mean (SD)	19.5 (5.8)	20.4 (7.2)	0.16
Positive parenting score, mean (SD)	15.2 (3.1)	15.1 (3.0)	0.82
Social support score, mean (SD)	17.6 (4.7)	17.5 (4.3)	0.74
Family functioning score, mean (SD)	9.1 (6.3)	9.4 (5.9)	0.60

Notes: Continuous and categorical variables are expressed as the mean (standard deviation) or frequency (percentage), respectively. The P-value was calculated based on a t-test for continuous variables and a chi-square test for categorical variables.

Abbreviation: SD, standard deviation.

Table 2 Comparing treated with untreated children in the intervention group

Baseline variable	Treated children (n = 111)	Untreated children (n = 118)	P-value
Child’s age, mean (SD)	7.3 (4.3)	8.3 (4.3)	0.09
Child’s sex, frequency (%)
Male	70 (63.1%)	78 (66.1%)	0.63
Female	41 (36.9%)	40 (33.9%)
Child’s diagnosis on admission, frequency (%)
Mental and developmental disorders	46 (41.4%)	60 (50.8%)	0.13
Diseases of the nervous system	32 (28.8%)	21 (17.8%)
Congenital abnormalities	21 (18.9%)	18 (15.3%)
Other disease	12 (10.8%)	19 (16.1%)
Child’s psychosocial score, mean (SD)	58.1 (19.0)	59.9 (18.4)	0.49
Parent’s age, mean (SD)	40.4 (6.9)	40.6 (8.3)	0.81
Marital status, frequency (%)
Married including common-law	92 (82.9%)	98 (83.1%)	0.97
Other	19 (17.1%)	20 (16.9%)
Parent’s education, frequency (%)
Secondary	40 (36.0%)	43 (36.8%)	0.91
Post-secondary	71 (64.0%)	74 (63.2%)
Family annual income, frequency (%)
<$30,000	19 (17.3%)	13 (11.0%)	0.34
$30,000–$90,000	58 (52.7%)	63 (53.4%)
<$90,000	33 (30.0%)	42 (35.6%)
Parent’s Kessler distress score, mean (SD)	20.2 (5.9)	18.8 (5.6)	0.09
Positive parenting score, mean (SD)	15.7 (3.2)	14.8 (3.0)	0.02
Social support score, mean (SD)	17.7 (4.6)	17.6 (4.9)	0.86
Family functioning score, mean (SD)	9.1 (6.4)	9.1 (6.3)	0.97

Notes: Continuous and categorical variables are expressed as the mean (standard deviation) or frequency (percentage), respectively. The P-value was calculated based on a t-test for continuous variables and a chi-square test for categorical variables.

Abbreviation: SD, standard deviation.

Figure 4 Comparing the estimates of treatment effect from different analyses.

Note: Mean difference refers to the difference in the change in psychosocial score in 2 years between groups.
Abbreviations: ITT, intention-to-treat; AT, as-treated; PP, per-protocol; IV, instrumental variable; PS, propensity score.

Table 3 Summary of estimates of treatment effect

	Multiple imputation				Raw data
	MD	95% CI		P-value	MD	95% CI		P-value
ITT analysisa	1.50	−1.49	4.50	0.32	–a	–	–	–
AT analysis
Matched by PS	−2.60	−7.45	2.24	0.29	−1.82	−6.49	2.86	0.45
Stratified by quintiles of PS	−0.89	−4.34	2.57	0.61	−1.17	−5.01	2.68	0.55
Weighted by PS	−0.75	−3.75	2.25	0.62	−0.80	−4.10	2.50	0.63
Adjusted by PS	−1.12	−4.62	2.39	0.53	−1.15	−4.99	2.70	0.56
PP analysis
Matched by PS	0.67	−3.44	4.78	0.75	2.26	−2.60	7.12	0.36
Stratified by quintiles of PS	0.37	−3.33	4.06	0.85	0.47	−3.58	4.52	0.82
Weighted by PS	0.21	−3.24	3.66	0.91	0.70	−3.16	4.56	0.72
Adjusted by PS	0.02	−3.23	3.27	0.99	−0.20	−3.71	3.31	0.91
IV analysis	3.10	−3.08	9.29	0.33	5.10	−0.78	10.97	0.09

Note:

a ITT analysis requires the inclusion of all randomized patients and was only performed when patients’ missing observations were imputed by multiple imputation.

Abbreviations: MD, mean difference (difference in change of psychosocial score over 2 years between groups); CI, confidence interval; ITT, intention-to-treat; AT, as-treated; PP, per-protocol; IV, instrumental variable; PS, propensity score.