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Efficacy Calculation in Randomized Trials: Global or Local Measures?


Emch, Michael E.; Ali, Mohammad; Acosta, Camilo; Yunus, Mohammad; Sack, David A.; & Clemens, John D. (2007). Efficacy Calculation in Randomized Trials: Global or Local Measures?. Health & Place, 13(1), 238-248.


This study tests whether the effect of a vaccine trial varies in space and why. Analytical z-score maps identify unusually high- and low-efficacy values in a trial area. Relationships between neighborhood efficacy and ecological variables are measured to explain why efficacy varies in space. Efficacy was found to vary regardless of neighborhood size and the variation is related to several ecological determinants. Local efficacy measures can help public health practitioners make better decisions about when and where to vaccinate populations. The concepts offered in this study are pertinent for any health intervention trial, not just vaccines.


Reference Type

Journal Article

Year Published


Journal Title

Health & Place


Emch, Michael E.
Ali, Mohammad
Acosta, Camilo
Yunus, Mohammad
Sack, David A.
Clemens, John D.