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October 31, 1998BMJ780 citationsOpen Access

The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials

RKRegina KunzAOAndrew D Oxman

Key Points

  • The review aims to assess the impact of random allocation on the apparent effects of care in clinical trials.
  • Review of empirical studies comparing randomised and non-randomised clinical trials.
  • Analysis of the effects of inadequate concealment of randomisation.
  • Comparison of distortion size against actual effect sizes.
  • Inadequate random allocation can significantly distort apparent treatment effects.
  • Distortions can be equal to or exceed the true effects intended to be measured.

Abstract

Failure to use adequately concealed random allocation can distort the apparent effects of care in either direction, causing the effects to seem either larger or smaller than they really are. The size of these distortions can be as large as or larger than the size of the effects that are to be detected.

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Cite This Study

Kunz et al. (1998) studied this question.

synapsesocial.com/papers/69dd42a5656f15f1fc100f5bhttps://doi.org/10.1136/bmj.317.7167.1185
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