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Clinical trials
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Clinical trials
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Claims: are they justified?
1-1 Treatments can harm
1-2 Anecdotes are unreliable evidence
1-3 Association is not the same as causation
1-4 Common practice is not always evidence-based
1-5 Newer is not necessarily better
1-6 Expert opinion is not always right
1-7 Beware of conflicting interests
1-8 More is not necessarily better
1-9 Earlier is not necessarily better
1-10 Hope may lead to unrealistic expectations
1-11 Explanations about how treatments work can be wrong
1-12 Dramatic treatment effects are rare
Comparisons: are they fair and reliable?
2-1 Comparisons are needed to identify treatment effects
2-2 Comparison groups should be similar
2-3 Peoples’ outcomes should be analyzed in their original groups
2-4 Comparison groups should be treated equally
2-5 People should not know which treatment they get
2-6 Peoples’ outcomes should be assessed similarly
2-7 All should be followed up
2-8 Consider all of the relevant fair comparisons
2-9 Reviews of fair comparisons should be systematic
2-10 Peer-review and publication does not guarantee reliable information
2-11 All fair comparisons and outcomes should be reported
2-12 Subgroup analyses may be misleading
2-13 Relative measures of effects can be misleading
2-14 Average measures of effects can be misleading
2-15 Fair comparisons with few people or outcome events can be misleading
2-16 Confidence intervals should be reported
2-17 Don’t confuse “statistical significance” with “importance”
2-18 Don’t confuse “no evidence” with “no effect”
Choices: making informed choices
3-1 Do the outcomes measured matter to you?
3-2 Are you very different from the people studied?
3-3 Are the treatments practical in your setting?
3-4 Do treatment comparisons reflect your circumstances?
3-5 How certain is the evidence?
3-6 Do the advantages outweigh the disadvantages?
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McMaster Evidence-Based Clinical Practice Workshop Resources – Systematic review module
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