This study will test the previously established efficacious HDHK program [ 14] in a larger effectiveness trial in five local government areas in the Hunter Valley in NSW, Australia.
Assay accuracy has a large effect on cost-effectiveness, since incorrect allocation to low risk groups increases the risk of distant recurrence as a result of under treatment.
Following the completion of the effectiveness study described here, we intend to conduct a large-scale effectiveness trial with an adequate number of schools necessary for conducting school level statistical analysis (e.g., linear mixed models).
Our findings can inform the design of a large-scale effectiveness randomized control trial.
This result would provide clear support for a larger comparative effectiveness trial testing ketamine as a prophylactic measure for both of these outcomes.
Furthermore, a next step would be to conduct a larger scale effectiveness study to test the actual contribution of ethnicity-based targeted recruitment approaches among close-knit ethnic communities that retain their own culture and language.
Testing the program presented in this article regionally within western Nepal in a large-scale effectiveness trial [ 12] will help to define its impact and identify areas for potential improvement in the program's model.
Our results come from a larger comparative effectiveness review of benefits and harms of second generation antidepressants, psychotherapies (including psychotherapies other than cognitive behavioral therapy), complementary and alternative medicine treatments, and exercise interventions for major depressive disorder funded by the US Agency for Healthcare Research and Quality.
In addition, given the lack of information about the likely size of the intra-class correlation coefficient (ICC), one intention of this study is to estimate this statistic to assist in sample size calculation for a larger subsequent effectiveness trial [ 20].
