Do RCTs Provide Better Evidence than Observational Studies?

Abstract

Evidence Based Medicine (EBM) was born on the premise that some commonly used treatments are not evidence-based. The EBM philosophy is that Randomised Clinical Trials (RCTs) alongside systematic reviews offer stronger evidential support than observational studies, mechanistic reasoning and expert judgement (Howick, 2011, 10). This paper argues that RCTs provide better evidential support than observational studies in two halves. Section I outlines EBM principles: it dissects RCTs and observational studies from an internal perspective. The foundation of Section I is that as long as RCTs entail less confounding factors than observational studies, they will provide superior evidential support1 (Howick, 2011, p.61). Section II will critique EBM ideology from an external perspective: if RCTs survive the criticisms then it is established that RCTs provide better evidential support than observational trials. It will start by analysing general principles and progress into scrutinising specific RCT devices. The conclusion is that RCTs withstand the criticism and are superior.

Keywords

Randomised Clinical Trials, Evidence Based Medicine

How to Cite

Sami, T. & Sedgwick, P., (2011) “Do RCTs Provide Better Evidence than Observational Studies?”, Opticon1826 11.

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Authors

Talha Sami (UCL)
Philip Sedgwick (UCL)

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