Block randomization

Indhumathi k
Msc Biostatistics
 Block randomization
• The block randomization method is designed to
randomize subjects into groups that result in
equal sample sizes.
• This method is used to ensure a balance in
sample size across groups over time.
• The block size is determined by the researcher
and should be a multiple of the number of
groups (i.e., with two treatment groups, block
size of either 4, 6, or 8).
 Continued…

• After block size has been determined, all possible

balanced combinations of assignment within the block
(i.e., equal number for all groups within the block)
must be calculated. Blocks are then randomly chosen
to determine the patients assignment into the groups.
• A block of four subjects for two treatments arms has
six different possible arrangements of 2As and 2Bs.
• AABB BBAA ABAB BABA ABBA BAAB.
• This process ensures numbers in each of the treatment
groups is similar at the end of each block.
• The disadvantage of this method is the
potential for the selection bias, at the end of
each block a person who keeps track of the
previous assignments could predict the next
assignment. To prevent such possibility of
prediction, the length or size of each block can
be varied.
Reference
• https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC3136079