Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Evidence-Based Practice
Lecture:Phrasing the clinical question
Interventions
Slide content:Other Issues for RCTs Quality of study inversely related to magnitude of treatment effect (Moher et al., 1998) Lower-quality (e.g., non-RCT) studies more likely to be later overturned (Ioannidis, 2005; Lehrer, 2010; Prasad, 2011; Savovi,2012 ) But well-designed observational studies may be just as good (Benson & Hartz , 2000; Dehabreh , 2012; Kovesdy , 2012) 6
Slide notes:6 There have been other interesting findings about RCTs over the years. One is that there seems to be an inverse relationship between the quality of the study and the magnitude of the treatment effectthe better the design of the study, the lower the treatment effect, or the benefit, of the treatment. Well see how this is actually measured in a moment. It has also been found that evidence of lower quality, particularly non-randomized controlled trials, is more likely to be later overturned than is good, high-quality evidence. However, it should be noted that well-designed observational studies in which you dont randomize and control people may be just as good as an RCT if the observational studies are well designed and well carried out.