ANCOVA Versus CHANGE From Baseline in Nonrandomized Studies: The Difference

The pretest-posttest control group design can be analyzed with the posttest as dependent variable and the pretest as covariate (ANCOVA) or with the difference between posttest and pretest as dependent variable (CHANGE). These 2 methods can give contradictory results if groups differ at pretest, a phenomenon that is known as Lord's paradox. Literature claims that ANCOVA is preferable if treatment assignment is based on randomization or on the pretest and questionable for preexisting groups. Some literature suggests that Lord's paradox has to do with measurement error in the pretest. This article shows two new things: First, the claims are confirmed by proving the mathematical equivalence of ANCOVA to a repeated measures model without group effect at pretest. Second, correction for measurement error in the pretest is shown to lead back to ANCOVA or to CHANGE, depending on the assumed absence or presence of a true group difference at pretest. These two new theoretical results are illustrated with multilevel (mixed) regression and structural equation modeling of data from two studies.