Most science does not rely on Rcts.
Rcts are very different to real world use.
Rcts randomly assign people to treatment or control groups.
But since this knowledge does not come from Rcts, it was ignored.
However, when they are ethical to provide, they help the reliabiliity of Rcts.
Within both Rcts, the primary endpoint was met
and no treatment related adverse events were reported.
The Rcts behind the trauma treatment guidelines considered only therapies of 16 sessions or fewer.
The diffuse and uncertain nature
of this condition makes the application of randomised controlled trials(Rcts) very difficult.
SCO Secretary-General and Rcts Executive Committee Director are appointed
by the HSC for a period of three years.
The main‘inside' criticisms of Rcts- from within the world of academic research(for example,
by recent Nobel Laureate Angus Deaton)- are as follows.
Here's an example:
Some people wrongly concluded that tooth flossing lacks scientific support after a review of Rcts found little evidence of benefits.
These recommendations are based on published data from randomised controlled trials(Rcts) and meta-analyses,
i.e. a collective evaluation of several Rcts to increase sample size(patient numbers).
But some people, primarily in the social sciences,
would have us believe that Rcts are the gold standard of scientific knowledge
and all else can be ignored.
More fundamentally, Rcts do not guarantee if something that worked in Kerala
will work in Bihar, or if something that worked for a small group will also work at scale.
Patients with HIV-2 need to be referred to HIV-2 experienced treatment centres and, at present, much of the advice is based on case studies,
as no randomised controlled trials(Rcts) are available.
For example, Rcts assessing the effectiveness of drug treatments are significantly more likely to report a positive effect if
the study was funded by the pharmaceutical industry than if funds came from non-industry sources.
Rcts in surgery generally are weaker studies than
large population-based studies because they are done at a single institution with large operator effect, rather than measuring directly the result of applying a new therapy to an entire population.
There is also some concern that, because Rcts require lots of funding, the missions
of certain donor agencies and philanthropic organisations may distort the direction of research- as much as the profit motive of pharmaceutical companies can influence the agenda of medical research.
The use of Rcts as the provider of“hard” and incontrovertible evidence has been questioned by many leading economists- none more so than Angus Deaton, the winner of the Economics Nobel in 2015, who said“randomisation does not equalise two groups”,
and warned against over-reliance on Rcts to frame policies.
Rcts, however, can mostly be applied to study
problems at the micro-level where the implementation of an individual programme- whether it is by the government or a private organisation(like a MFI or an NGO)- can be done in a randomised way that allows for a statistically satisfactory evaluation of the programme's impact, as outlined earlier.