Randomization
cancer, sarcoma, GI cancer
CANCER, SARCOMA, GI CANCER
In a stepped-wedge cluster randomized study, clusters are randomized to sequences; each sequence represents a timeline of implementation for clusters in that sequence, with the transition to implementation for clusters in each sequence occurring in a different step. The 15 cancer care teams represented 11 teams at Mayo Clinic Rochester (RST) and 4 Mayo health system community clinics in Southwest Wisconsin [SWWI], Northwest Wisconsin [NWWI], Southwest Minnesota [SWMN], and Southeast Minnesota [SEMN]. These 15 cancer care teams were randomized to 5 sequences, stratified on 3 factors:
Annual volume, categorized as <4000, 4001–8000, and 8000+ using the calendar year prior to E2C2 initiationRST team cancer type: head/neck, genitourinary (GU), lung, sarcoma, gastrointestinal (GI), breast, gynecological, brain, and general/endocrine, and mixed (the 4 community sites)RST GI team: Mayo Rochester has 2 GI cancer care teams; internally (and in Fig. Final allocation of 15 cancer care sites to 5 sequences over 6 time periodsThe interactions of these three factors included many empty cells, resulting in only 4 distinct strata. Randomization was performed using a computer program which allocated clusters by strata to sequences. All clusters were randomized by the study statistician (JH) prior to the study start, and the allocations revealed to all clusters at the beginning of the study. The assignment to strata and sequences is illustrated in Fig. 