Document Detail

How can good randomized controlled trials in leading journals be so misinterpreted?
MedLine Citation:
PMID:  23336854     Owner:  NLM     Status:  In-Data-Review    
The results of good randomized controlled trials (RCTs) published in leading peer-reviewed journals have been deemed the best possible basis for good medical practice. However, several limitations may decrease their value. These include flaws and weaknesses in the design and the timeliness of RCTs. Progress in a treatment method or control arm may invalidate a trial. So too can defects in patient selection, physician competence, randomization, applicability, end points, and the population being studied. Idiosyncratic flaws can also invalidate an RCT. Examples of these flaws and weaknesses are presented. Another problem with articles describing RCTs is the potential for the conclusions of the trial report to be misleading because of error or bias. This plus subsequent misinterpretation of the trial results or conclusions by others can make the effect of the trial misleading with an unintended detrimental result on medical practice. Guidelines based on such errors or bias-based conclusions and misinterpretations can further compound the problem. This article provides examples of misleading conclusions and/or misinterpretations (spinning) of trial results in articles describing RCTs in leading journals. All physicians should recognize these value-limiting processes so that RCTs can be evaluated adequately and fairly. In that way, they can be used along with good physician judgment to optimize the care delivered to individual patients and to society at large.
Frank J Veith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  57     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3S-7S     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Divisions of Vascular Surgery, New York University Medical Center, New York, NY; and The Cleveland Clinic, Cleveland, Ohio. Electronic address:
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