Key result
Nonrandomized studies remain essential when RCTs are unavailable, impractical, or unethical.
Why the study?
Randomized clinical trials are often unavailable, impractical, or unethical for assessing health interventions, necessitating evaluation of nonrandomized study findings.
Key points are not available for this paper at this time.
Design
Review of nonrandomized studies of interventions
May inform practice when RCTs infeasible; leaves open standardized credibility criteria for nonrandomized cardiovascular evidence.
Randomized clinical trials (RCTs) are widely accepted as the gold standard in the assessment of health interventions. However, evidence from RCTs is often unavailable. Randomized clinical trials may also be impractical, for example when the outcome of interest is so rare or so long term that appropriately sized studies would be too expensive. In addition, RCTs require clinical equipoise, and withholding established treatments may be considered unethical even if evidence for the effects of these treatments is limited. Finally, RCTs may be underway but not ready for reporting for some years.
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McGuinness et al. (2018) reported a review. Randomized clinical trials are the gold standard for assessing health interventions, but nonrandomized studies are often necessary when RCTs are unavailable, impractical, or unethical.
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