Randomized-Controlled Trials, Benefit of Scepticism

Same treatmentsfor diseases have been ıhoughtto produce large effects on death or disability. Such expectations might derive from extrapolation of the effects of treatment on surrogate outcomes. For example, cardiac arrhythmias are associated witlı poor prognosis, and antiarrlıyıhmic drıtgs can markedly reduce tlıeirfrequency. However, various antiarrlıythmic regimens have beenfound to increase, rather than decrease mortality. So, trials of new tlıe rapies in medicine should typically conıpare the new treatment to a control group. The control group receives the treatment agahıst whiclı the test intervention is being compared. These Irials as referred as controlled trials. Randomized controlled trials typically involve the randomizaıion. of patients to either the control or test treatments. Randomization has importanl constructive injluences on seleelian bias or likelilıood of comparab/e groups. These trials are the go/d standard for eva/uaıing new therapies, and they form the foundation for the /ıighestlevels of recommendation in practice gıtideline documents that stress ev idence based medicine. Although suc/ı Irials provide valid comparison of therapies, the generalizatian of results must be analyzed cautiously. In this article we discussed some possible drawbacks ofrandomized-conırolled ırials. Clinicians should be aware oftlıe drawbacks ofrandomized controlled Irials during the interpretation of results.