Comment on "Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial".

We read the article “Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial” by Chan et al [1] with great interest. The idea that face to face education is difficult and education via the internet or social networking systems is necessary is intriguing; this is an important perspective in the midst of the COVID-19 pandemic. In the article, the editor wrote, “readers are advised to carefully assess the validity of any potential explicit or implicit claims related to primary outcomes or effectiveness”; hence, we would like to discuss some perspectives.

First, the primary outcome was measured using the differences in the scores of the pre- and postintervention knowledge assessments, which comprised the 25-item Dementia Knowledge Assessment Scale (DKAS) and a formative evaluation of 20 multiple-choice questions. However, the authors’ conclusion is focused on the outcome of improving participants’ knowledge concerning a single subscale in DKAS. This interpretation might be a spin that could warp the interpretation of results and mislead readers [2].

Second, the article has issues with multiple testing. When tests are divided into subscales, some of them may have significant differences. To show a significant difference in the effect, corrections to the multiple tests are required [3].

Finally, this study is a pre and post study; therefore, a paired t test should be used instead of a two-sample t test. The two-sample t test estimates the treatment effect using only the responses at follow-up, and it does not use any information at baseline, which may be useful for increasing efficiency if the baseline and follow-up outcomes are correlated [4].