A Medical Educator's Guide to Thinking Critically about Randomised Controlled Trials: Deconstructing the "Gold Standard"

Beschreibung

Drawing on the statistical and philosophical expertise of its authors, this book is designed to improve understanding and use of randomised controlled trials (RCTs) among health professionals. It is intended for use primarily by medical educators involved in teaching statistics and evidence-based medicine (EBM) to medical students, junior doctors and other health professionals. However, each of the chapters serves a wider range of interests, including the practical needs of physicians in interpreting research evidence to support clinical decision making and the teaching needs of  philosophers of medicine who want to more fully appreciate how RCTs work in practice and provide engaging examples for their students.

Rather than compete with the proliferating methodological literature on RCT designs, this book focuses on cultivating a healthy skepticism among developing health professionals to support critical appraisal of their own and published work on RCTs at a fundamental level, including through a more informed understanding of the place of subgroup analyses in sound statistical inference. Management of the positive predictive value in the statistical analysis of RCT findings is included as an important topic for contemporary medical curricula.  In comparing  RCTs with non-randomised studies, a search for empirical evidence for the superiority of RCTs is initiated, pointing to the need for further work to confirm what form this evidence should take.

Drawing on the statistical and philosophical expertise of its authors, this book is designed to improve understanding and use of randomised controlled trials (RCTs) among health professionals. It is intended for use primarily by medical educators involved in teaching statistics and evidence-based medicine (EBM) to medical students, junior doctors and other health professionals. However, each of the chapters serves a wider range of interests, including the practical needs of physicians in interpreting research evidence to support clinical decision making and the teaching needs of  philosophers of medicine who want to more fully appreciate how RCTs work in practice and provide engaging examples for their students.

Rather than compete with the proliferating methodological literature on RCT designs, this book focuses on cultivating a healthy skepticism among developing health professionals to support critical appraisal of their own and published work on RCTs at a fundamental level, including through a more informed understanding of the place of subgroup analyses in sound statistical inference. Management of the positive predictive value in the statistical analysis of RCT findings is included as an important topic for contemporary medical curricula.  In comparing  RCTs with non-randomised studies, a search for empirical evidence for the superiority of RCTs is initiated, pointing to the need for further work to confirm what form this evidence should take.

Medical educators will find a wealth of reasons to encourage their students to think more critically about how the RCT operates in practice as a gold standard.

Autor*in

Margaret MacDougall

Themen in »A Medical Educator's Guide to Thinking Critically about Randomised Controlled Trials: Deconstructing the "Gold Standard"«

97B30, 62-02, 92C50, 62K05 62A01, 62P10, 97-02 Randomized controlled trials Medical statistics Randomization Observational studies Non-randomized trials False positive reporting probability Confounding Causal Inference Pragmatic designs Research ethics Subgroup analyses Statistical reporting A priori intuition

Stimmen zu »A Medical Educator's Guide to Thinking Critically about Randomised Controlled Trials: Deconstructing the "Gold Standard"«

“This book represents a well-written resource for health professionals and medical educators alike. Too often, RCTs are misconstrued as irreproachable based on their status as the gold standard of quantitative primary research or in contrast, criticised on account of implementation challenges when compared to observational studies. By bringing together in one volume a range of edited contributions from leading statisticians and philosophers, this work adds a much-needed balanced perspective on the status of RCTs in clinical research. Typically, curricula for medical students focus little on philosophical issues and too much on the practical mechanics of research. This book also helps redress the disciplinary balance needed here. Medical educators will find much practical content to add a more nuanced discussion of study design to their teaching.” (Paul D Baxter, Professor of Biostatistics & Education, University of Leeds)

Details

Link teilen