Regression to the mean: what it is and how to deal with it.
BACKGROUND
Regression to the mean (RTM) is a statistical phenomenon that can make natural variation in repeated data look like real change. It happens when unusually large or small measurements tend to be followed by measurements that are closer to the mean.


METHODS
We give some examples of the phenomenon, and discuss methods to overcome it at the design and analysis stages of a study.


RESULTS
The effect of RTM in a sample becomes more noticeable with increasing measurement error and when follow-up measurements are only examined on a sub-sample selected using a baseline value.


CONCLUSIONS
RTM is a ubiquitous phenomenon in repeated data and should always be considered as a possible cause of an observed change. Its effect can be alleviated through better study design and use of suitable statistical methods.
Barnett
Adrian G
AG
School of Population Health, The University of Queensland, Herston, Brisbane, QLD 4006, Australia. a.barnett@uq.edu.au
van der Pols
Jolieke C
JC
Dobson
Annette J
AJ
D008076:Cholesterol, HDL / Q000097:blood; D002986:Clinical Trials as Topic / Q000379:methods; D003627:Data Interpretation, Statistical; D006801:Humans; D012044:Regression Analysis; D012107:Research Design; D012878:Skin Neoplasms / Q000517:prevention & control
D008076:Cholesterol, HDL