Cited by 165Statistical Methods in Clinical TrialsHealth Policy Implementation ScienceMeta-analysis and systematic reviews

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Pragmatic randomised controlled trials in psychiatry

Hotopf, Matthew, Churchill, Rachel, Lewis, Glyn·1999·British Journal of Psychiatry

DOI 10.1192/bjp.175.3.217

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Abstract

BACKGROUND: Randomised controlled trials (RCTs) are the most important method of evaluating new treatments and treatment policies. Despite this, there are relatively few large pragmatic RCTs in psychiatry. AIMS: To explore the main advantages of large pragmatic RCTs and the obstacles to performing them in psychiatry. METHOD: A narrative review of literature on pragmatic RCTs with examples drawn from psychiatry and other medical specialities. RESULTS: Obstacles to performing pragmatic RCTs in psychiatry include the complexity of psychiatric interventions, the complexity of outcomes used in psychiatry and the difficulties of blinding subjects and investigators to some psychiatric interventions. CONCLUSIONS: Researchers need to frame questions in a form that is relevant to clinicians and to convince clinicians to cooperate in simple large pragmatic trials.

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Authors: Hotopf, M., Churchill, R., & Lewis, G.
Affiliations: Guy's Hospital (GB)
Cardiff University (GB)
Corresponding author: Hotopf, Matthew
ORCID: Hotopf, Matthew
Churchill, Rachel
Lewis, Glyn
Venue: British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
Published: 1999-09
Volume: 175
Issue: 3
Pages: 217-223
ISSN: 0007-1250 (ISSN-L)
1472-1465
DOI: 10.1192/bjp.175.3.217
OpenAlex: W2058332740
Cited by: 165
References: 42
Citations by year: 2025: 2 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 7 · 2014: 2 · 2013: 5 · 2012: 9
FWCI: 2.23
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified, 6699 d)
Locations: The British Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics: Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Keywords: pragmatic randomized controlled trial, psychiatry, mental health outcomes, clinician involvement in research, research question formulation
MeSH terms: Mental Disorders, Costs and Cost Analysis, Ethics, Medical, Humans, Prognosis, Random Allocation, Observer Variation, Cluster Analysis, Randomized Controlled Trials as Topic, Patient Satisfaction, Patient Selection

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