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Pair-matching with random allocation in prospective controlled trials: the evolution of a novel design in criminology and medicine, 1926–2021

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Abstract

Objectives

Pair-matching with random allocation in prospective controlled trials represents a novel and highly rigorous design. First use of the design can be traced to medicine (in 1926) and criminology and the social sciences more generally (in 1935). Beginning with these trials, we examine the subsequent history of matched-pair RCTs (randomized controlled trials), and related attention to stratification prior to randomization, in both criminology and medicine over almost a century to illustrate shared interest in the design’s advantages and disadvantages.

Methods

We draw upon a wide range of historical and contemporary sources, including historical archives and writings on the first trials in criminology and medicine, prior reviews of RCTs and matched-pair RCTs, and searches of selected databases.

Results

The first trials draw attention to key factors that remain central to contemporary use, including concerns about covariate imbalance when randomization is used on its own, potential to improve study power when matching is effective, and the ability to deal with differential attrition in follow-ups. The evolution of the design also shows that the single most important application of matched-pair RCTs is when the units are clusters or places.

Conclusions

Over the twentieth and twenty-first centuries, criminology and medicine have continued to wrestle with methodologies to most efficiently and robustly compare like with like. Both, in this setting, have turned to matched-pair randomization, though less often than its advocates would like. It is this and other shared interests between criminology/social sciences and medicine/public health, including a movement toward evidence-based policy and practice, that help us reimagine possibilities for advancing knowledge and improving public policy.

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Notes

  1. In medicine and public health, this design is more commonly referred to as matched-pair, cluster-randomization (or MPCR; Imai et al., 2009a). Other names for the matching component in RCTs include adaptive pair-matching and nonbipartite matching (Balzer et al., 2015). In the social sciences, a matched-pair RCT is sometimes referred to as a complete or fully blocked design. In contrast, a partially blocked design involves some type of stratifying of the cluster-based units prior to random allocation to treatment and control conditions (Weisburd & Gill 2014).

  2. On the transition from alternate allocation studies (in which, e.g., every other patient was administered the novel remedy) to studies that entailed allocation by concealed randomization, see Chalmers (2005), Chalmers et al. (2012), and Bothwell and Podolsky (2016).

  3. Using the search term “were matched” called up 550 papers in the NEJM database. The first related to “matching” in a methodological sense dates from 1954, though in a review (Viets 1954). The examples described here are ones in which studies were actually conducted, rather than reported in a review article.

  4. In this context, Bruhn and McKenzie (2009) note that stratification occurs when “units are randomly assigned to treatment and control within strata defined by usually one or two observed baseline characteristics” (p. 201), while pair-matching “provides a method to improve covariate balance for many variables at the same time” (p. 209).

  5. As described by the authors, “A notable feature of the survey responses was a much greater number of researchers randomizing within matched pairs than is apparent from the existing development literature” (Bruhn and McKenzie 2009, p. 206).

  6. The proportion of trials that used pair-matching compared to other forms of stratification was not specified.

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Acknowledgements

We thank the journal editor and the anonymous reviewers for helpful comments.

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Authors and Affiliations

  1. School of Criminology and Criminal Justice, Northeastern University, Churchill Hall, 360 Huntington Avenue, Boston, MA, 02115, USA

    Brandon C. Welsh

  2. Harvard Medical School, Boston, MA, USA

    Scott H. Podolsky

  3. Florida State University, Tallahassee, FL, USA

    Steven N. Zane

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Welsh, B.C., Podolsky, S.H. & Zane, S.N. Pair-matching with random allocation in prospective controlled trials: the evolution of a novel design in criminology and medicine, 1926–2021. J Exp Criminol 19, 1115–1130 (2023). https://doi.org/10.1007/s11292-022-09520-2

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