Titre du document / Document title

The evolution of the randomized controlled trial and its role in evidence-based decision making

Auteur(s) / Author(s)

DEVEREAUX P. J. ⁽¹⁾ ; YUSUF S. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Medicine and Population Health Research Institute. McMaster University, Hamilton, Ontario, CANADA

Résumé / Abstract

The randomized controlled trial has been used in medical research for a little over half a century. This manuscript provides an overview of some of the history and evolution of the randomized controlled trial during this period. There exists hierarchies of evidence for therapeutic, diagnostic and prognostic questions, and the randomized controlled trial is at the top of the therapeutic hierarchy. Despite being at the top of the therapeutic hierarchy randomization in itself does not guarantee the trial results approximate the true effect. Issues that result in systematic and nonsystematic deviations from the truth in randomized controlled trials must also be considered. We present a model for evidence-based decision making that includes the following components: the clinical state, patient preferences, research evidence from a range of studies and clinical expertise. We discuss the role of the randomized controlled trial within evidence-based decision making.

Revue / Journal Title

Journal of internal medicine   ISSN 0954-6820 

Source / Source

2003, vol. 254, n^o2, pp. 105-113 [9 page(s) (article)] (55 ref.)

Langue / Language

Anglais

Editeur / Publisher

Blackwell Science, Oxford, ROYAUME-UNI  (1989) (Revue)

Mots-clés anglais / English Keywords

Human ; Evidence-based medicine ; Prognosis ; Treatment ; Diagnosis ; Medicine ; Scientific research ; Controlled environment study ; Randomization ; Clinical trial ;

Mots-clés français / French Keywords

Homme ; Médecine factuelle ; Pronostic ; Traitement ; Diagnostic ; Médecine ; Recherche scientifique ; Etude en condition contrôlée ; Randomisation ; Essai clinique ;

Mots-clés espagnols / Spanish Keywords

Hombre ; Medicina basada en pruebas ; Pronóstico ; Tratamiento ; Diagnóstico ; Medicina ; Investigación científica ; Estudio en condición controlada ; Aleatorización ; Ensayo clínico ;

Mots-clés d'auteur / Author Keywords

evidence-based medicine ; hierarchies of evidence ; randomized controlled trial ;

Localisation / Location

INIST-CNRS, Cote INIST : 893 A, 35400011986610.0020