Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
The double-blind, randomized, placebo-controlled trial: Gold standard or golden calf?
Autore:
Kaptchuk, TJ;
Indirizzi:
Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Boston, MA 02215 USAHarvard Univ Boston MA USA 02215 Deaconess Med Ctr, Boston, MA 02215 USA
Titolo Testata:
JOURNAL OF CLINICAL EPIDEMIOLOGY
fascicolo: 6, volume: 54, anno: 2001,
pagine: 541 - 549
SICI:
0895-4356(200106)54:6<541:TDRPTG>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
UNDERSTANDING CONTROLLED TRIALS; NONRANDOMIZED CLINICAL-TRIALS; DESIGN AFFECTS OUTCOMES; INFORMED CONSENT; HISTORICAL CONTROLS; GENERAL-PRACTICE; METAANALYSIS; QUALITY; THERAPY; CANCER;
Keywords:
double-blind randomized controlled trial; gold standard; bias; artifacts; placebo;
Tipo documento:
Editorial Material
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
99
Recensione:
Indirizzi per estratti:
Indirizzo: Kaptchuk, TJ Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, 330 Brookline Ave,KW-400, Boston, MA 02215 USA Harvard Univ 330 Brookline Ave,KW-400 Boston MA USA 02215 USA
Citazione:
T.J. Kaptchuk, "The double-blind, randomized, placebo-controlled trial: Gold standard or golden calf?", J CLIN EPID, 54(6), 2001, pp. 541-549

Abstract

The double-blind randomized controlled trial (RCT) is accepted by medicineas objective scientific methodology that, when ideally performed, producesknowledge untainted by bias. The validity of the RCT rests not just on theoretical arguments, but also on the discrepancy between the RCT and less rigorous evidence (the difference is sometimes considered an objective measure of bias). A brief overview of historical and recent developments in "the discrepancy argument" is presented. The article then examines the possibility that some of this "deviation from truth" may be the result of artifacts introduced by the masked RCT itself. Can an "unbiased" method produce bias? Among the experiments examined are those that augment the methodological stringency of a normal RCT in order to render the experiment less susceptible to subversion by the mind. This methodology, a hypothetical "platinum" standard, can be used to judge the "gold" standard. The concealment in a placebo-controlled RCT seems capable of generating a "masking bias. " Other potential biases, such as "investigator self-selection" "preference," and "consent" are also briefly discussed. Such potential distortions indicate that the double-blind RCT may not be objective in the realist sense, but rather is objective in a "softer" disciplinary sense. Some "facts" may not exist independent of the apparatus of their production. (C) 2001 Elsevier Science Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:23:35