Will this trial find that paying people to lose weight results in more weight loss than usual care?
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resolved Mar 21
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The comparison is between the:
- Outcome-based group ($50-100 a month if they lose ≥1.5% to <2.5% of baseline weight or $100-150 a month if they lose ≥2.5% of baseline weight) + all the control group stuff.
- Control group: fitbit, food diary, referral to weight watchers etc.
The outcome measure: Percentage of patients who achieve 5% reduction from Baseline Weight at 6 months. If the confidence intervals don't include 0, it resolves to yes.
Here is the trial registration:
https://clinicaltrials.gov/ct2/show/NCT03157713?term=behavioral+economics&recrs=e&rslt=Without&type=Intr&draw=3&rank=58
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Results here: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2799223. "At 6 months, the adjusted proportion of patients who lost at least 5% of baseline weight was 22.1% in the resources-only group, 39.0% in the goal-directed group, and 49.1% in the outcome-based incentive group (difference, 10.08 percentage points [95% CI, 1.31-18.85] for outcome based vs goal directed; difference, 27.03 percentage points [95% CI, 18.20-35.86] and 16.95 percentage points [95% CI, 8.18-25.72] for outcome based or goal directed vs resources only, respectively)".
And I bet no.
I'd guess the intervention probably does work, but will the confidence intervals include 0? In this (doi:10.1111/obr.12657) review of 12 studies, only 4 had p<.05. The study in question has a decent sample size, but they have also selected a binary (% with 5% loss) as the main outcome and, afaik, you lose power with a binary outcome. All in all, I think there is a reasonable chance of a non-significant difference.
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