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Evaluation Review
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Differential Attrition

Estimating the Effect of Crossovers on the Evaluation of a Medical Technology

William H. Yeaton

Institute for Social Research

Paul M. Wortman

School of Public Health and Institute for Social Research The University of Michigan at Ann Arbor

Naftali Langberg

University of Haifa

The differential attrition of persons from comparison groups severely restricts the inferences that can be made from results of evaluative research. This problem is particularly troublesome in the evaluation of medical technologies, such as coronary artery bypass graft surgery, since a substantial percentage of medical or control patients cross over to the surgical group. A procedure using worst case assumptions is developed that allows researchers to estimate the maximum effect of differential attrition, and therefore enhance the quality of their inferences. The article first illustrates theprocedure, then concludes with a discussion of the generality of the estimation procedure to other instances in which differential attrition is a problem, and points out the limitations of the approach.

Evaluation Review, Vol. 7, No. 6, 831-840 (1983)
DOI: 10.1177/0193841X8300700607
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