Saturday, May 15, 2010

RCT Snark

From the comments section at Aid Watch recently after bemoaning the fact that the New Yorker wasn't taking critics and criticisms of randomized control trials seriously:
I can see it now… A well-meaning RCT acolyte popping up on NPR to talk about the Aravind Eye Hospital and saying
Well, yes, it is true that they have cured two million people of blindness in thirty years. But we don’t have any real evidence of their effectiveness. How many of the people treated at Aravind would have ceased to be blind without the surgery they received? Was the Aravind approach really better than alternatives? And did it really have an impact on economic growth in the regions in question? The only thing I can say without proper evaluation is that this is a nice retirement project. But I can’t tell you that it is effective development.
 and this one

I heartily commend to all this 2003 article by Gordon Smith and Jill Pell “Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials”...
Results We were unable to identify any randomised controlled trials of parachute intervention.
Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.

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