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Randomized controlled trials – a matter of design
Open accessAbstract
Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial.
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“Despite their importance, issues in the methodology and study design can introduce bias, random error, or limit the generalizability of RCTs (Spieth et al. 2016; Wambier et al. 2022).”
From Adherence to the CONSORT statement of randomized clinical trials on dentin hypersensitivity treatment using mouthwashes (2025) · cites this paper as Spieth et al. 2016
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Metadata
- Authors
- Siepmann, T., Spieth, P. M., Kubasch, A. S., Penzlin, A. I., Illigens, B. M.-W., & Barlinn, K.
- Affiliations
- John Radcliffe Hospital (GB)
- Dresden International University (DE)
- University Hospital Carl Gustav Carus (DE)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Siepmann, Timo
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2016-06
- Volume
- 12
- Pages
- 1341
- ISSN
- 1176-6328 (ISSN-L)
- 1178-2021
- PMC
- PMC4910682
- OpenAlex
- W2410316792
- Cited by
- 292
- References
- 66
- Citations by year
- 2026: 7 · 2025: 42 · 2024: 45 · 2023: 39 · 2022: 30 · 2021: 52 · 2020: 33 · 2019: 33 · 2018: 10 · 2017: 1
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by)
- Funders
- Technische Universität Dresden
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Keywords
- randomized controlled trials, trial design, critical appraisal, equipoise, CONSORT statement, clinical trial registration, conflicts of interest, interim analysis, clinical trial reporting, end points, critical care research, brain research
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