Learning Objectives
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1.
Randomized trials should be considered when:
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a.
There is uncertainty regarding the effect of an exposure or treatment
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b.
The exposure can be modified in a trial setting
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a.
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2.
Phase I and phase II studies evaluate the tolerability and biological activity of a drug; phase III and phase IV studies are randomized trials that evaluate clinical endpoints.
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3.
Potential limitations of randomized trials include:
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a.
Limited generalizability of the study population
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b.
Limited generalizability of the study environment
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c.
Randomized trials address a narrow study question
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d.
Randomized design accounts only for confounding
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a.
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4.
Common measures of effect in randomized trials are relative risk and risk difference.
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5.
The number needed to treat or harm = 1/risk difference.
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6.
The intention-to-treat analysis predictably leads to bias toward the null.
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7.
Criteria used to judge whether results of a subgroup analysis are valid include:
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a.
Biological plausibility for a particularly strong effect in the subgroup
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b.
The subgroup analysis was pre-specified
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c.
Reasonably large number of outcomes in the subgroup
-
a.
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Kestenbaum, B. (2009). Randomized Trials. In: Epidemiology and Biostatistics. Springer, New York, NY. https://doi.org/10.1007/978-0-387-88433-2_7
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DOI: https://doi.org/10.1007/978-0-387-88433-2_7
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