| Factorial design provides evidence to guide practice of anaesthesia. | |
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MedLine Citation:
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PMID: 16045652 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Many scientific articles are written merely to get something published, neglecting the clinician who would like the medical literature to guide their practice. Evidence-based medicine is expected to help in clinical decision-making. Systematic reviews of the literature followed by a meta-analysis of randomized, controlled trials (RCT) have claimed to represent the highest strength of evidence. However, the results published in meta-analyses have not always been confirmed in subsequent large RCTs. An analysis of 12 large RCTs and 19 meta-analyses addressing the same questions found that the outcomes of these large RCTs were not predicted accurately 35% of the time by previously published meta-analyses. Therefore, meta-analyses of several small RCTs do not obviate the need for large, multicentre RCTs, which can still be considered as a gold standard for the development of clinical guidelines or practice plans. Moreover, large RCTs using a factorial design can be highly efficient because they can answer several clinical questions at the same time and offer the only systematic approach to investigate an interaction of combinations in multimodal approaches. |
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Authors:
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K Korttila; C C Apfel |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 49 ISSN: 0001-5172 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-07-27 Completed Date: 2005-11-03 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: Denmark |
Other Details:
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Languages: eng Pagination: 927-9 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland. kari.korttila@hus.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia
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methods* Evidence-Based Medicine Humans Meta-Analysis as Topic Practice Guidelines as Topic Randomized Controlled Trials as Topic* Research Design* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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