Randomised Controlled Trials: Gold Standard Research?

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Randomised Controlled Trials: Gold Standard Research?

Post by Guest23 » Tue Apr 17, 2007 6:28 pm

Re: +/- of RCTs…

- Random assignment doesn’t guarantee equivalence of groups
- Leakage problems
- Staff not cooperating
- Cost & time
- Unlikelihood of a completely ‘attrition-free’ trial

In terms of ethics:
- Types of control groups (no treatment, placebo, wait-list etc)
- Randomisation vs participant choice/preference (of therapy)
- Study-specified treatment vs clinical judgement
- Referrals at termination
- Cannot look at negative experiences - aversive studies not possible (thank the Lord!)

Generalising to clinical practice:
- Restrictive inclusion criteria (good internal validity) - no comorbidity vs ca. 95% in NHS
- Manualised therapies of fixed duration

Essentially it’s the ‘Efficacy vs Effectiveness’ argument… could also link it into evidence-based practice….
For a very quick summary see for instance pp. 153-161 (in particular pp. 156-7) in Barker et al.’s (2002) Research Methods in Clinical Psychology (2nd ed.); Wiley. ISBN: 047149089X
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