Randomised controlled trials: important but overrated?

Hdl Handle:
http://hdl.handle.net/10147/207014
Title:
Randomised controlled trials: important but overrated?
Authors:
Boylan, J F; Kavanagh, B P; Armitage, J
Affiliation:
St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. jboylan@iol.ie
Citation:
J R Coll Physicians Edinb. 2011 Jun;41(2):126-31.
Journal:
The journal of the Royal College of Physicians of Edinburgh
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207014
DOI:
10.4997/JRCPE.2011.216
PubMed ID:
21677918
Abstract:
Practising physicians individualise treatments, hoping to achieve optimal outcomes by tackling relevant patient variables. The randomised controlled trial (RCT) is universally accepted as the best means of comparison. Yet doctors sometimes wonder if particular patients might benefit more from treatments that fared worse in the RCT comparisons. Such clinicians may even feel ostracised by their peers for stepping outside treatments based on RCTs and guidelines. Are RCTs the only acceptable evaluations of how patient care can be assessed and delivered? In this controversy we explore the interpretation of RCT data for practising clinicians facing individualised patient choices. First, critical care anaesthetists John Boylan and Brian Kavanagh emphasise the dangers of bias and show how Bayesian approaches utilise prior probabilities to improve posterior (combined) probability estimates. Secondly, Jane Armitage, of the Clinical Trial Service Unit in Oxford, argues why RCTs remain essential and explores how the quality of randomisation can be improved through systematic reviews and by avoiding selective reporting.
Language:
eng
MeSH:
Bayes Theorem; Bias (Epidemiology); Humans; *Randomized Controlled Trials as Topic/methods/standards/utilization; *Research Design
ISSN:
2042-8189 (Electronic); 1478-2715 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBoylan, J Fen_GB
dc.contributor.authorKavanagh, B Pen_GB
dc.contributor.authorArmitage, Jen_GB
dc.date.accessioned2012-02-01T10:28:12Z-
dc.date.available2012-02-01T10:28:12Z-
dc.date.issued2012-02-01T10:28:12Z-
dc.identifier.citationJ R Coll Physicians Edinb. 2011 Jun;41(2):126-31.en_GB
dc.identifier.issn2042-8189 (Electronic)en_GB
dc.identifier.issn1478-2715 (Linking)en_GB
dc.identifier.pmid21677918en_GB
dc.identifier.doi10.4997/JRCPE.2011.216en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207014-
dc.description.abstractPractising physicians individualise treatments, hoping to achieve optimal outcomes by tackling relevant patient variables. The randomised controlled trial (RCT) is universally accepted as the best means of comparison. Yet doctors sometimes wonder if particular patients might benefit more from treatments that fared worse in the RCT comparisons. Such clinicians may even feel ostracised by their peers for stepping outside treatments based on RCTs and guidelines. Are RCTs the only acceptable evaluations of how patient care can be assessed and delivered? In this controversy we explore the interpretation of RCT data for practising clinicians facing individualised patient choices. First, critical care anaesthetists John Boylan and Brian Kavanagh emphasise the dangers of bias and show how Bayesian approaches utilise prior probabilities to improve posterior (combined) probability estimates. Secondly, Jane Armitage, of the Clinical Trial Service Unit in Oxford, argues why RCTs remain essential and explores how the quality of randomisation can be improved through systematic reviews and by avoiding selective reporting.en_GB
dc.language.isoengen_GB
dc.subject.meshBayes Theoremen_GB
dc.subject.meshBias (Epidemiology)en_GB
dc.subject.meshHumansen_GB
dc.subject.mesh*Randomized Controlled Trials as Topic/methods/standards/utilizationen_GB
dc.subject.mesh*Research Designen_GB
dc.titleRandomised controlled trials: important but overrated?en_GB
dc.contributor.departmentSt Vincent's University Hospital, Elm Park, Dublin 4, Ireland. jboylan@iol.ieen_GB
dc.identifier.journalThe journal of the Royal College of Physicians of Edinburghen_GB
dc.description.provinceLeinster-

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