Orthogonal Design: A Powerful Method for Comparative Effectiveness Research with Multiple Interventions

There is a growing interest in new or modified research methods that can balance the needs for quick results and statistical rigor in studies of intervention effectiveness. Orthogonal design, which has been extensively used in manufacturing and other fields but not in published health care evaluations or comparative effectiveness research (CER), affords an opportunity to design interventions in real-world settings and to study intervention components that can be implemented in various ways. This brief introduces orthogonal design, describes key design and implementation considerations, and illustrates how it can be applied in CER studies by describing its use in an ongoing study of care coordination delivery by Special Needs Plans (SNPs) to dually eligible individuals.