Randomized controlled trials in psychiatry. Part II: their relationship to clinical practice.
OBJECTIVE: To discuss the extent to which the results of randomized controlled trials (RCTs) in psychiatry can be generalized to clinical practice. METHOD: Threats to internal and external validity in psychiatric RCTs are reviewed. RESULTS: Threats to internal validity increase the possibility of bi...
| Publicado en: | Australian & New Zealand Journal of Psychiatry Vol. 37; no. 3; pp. 265 - 270 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Sage Publications Inc.
Jun2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106717211&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106717211 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Jun2003 vid: 37 iid: 3 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 106717211 106717211 2004049593 10.1046/j.1440-1614.2003.01176.x NLM12780463 106717211 ppf: 265 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Randomized controlled trials in psychiatry. Part II: their relationship to clinical practice. aug: au: Mulder RT Frampton C Joyce PR Porter R affil: Department of Psychological Medicine, Christchurch School of Medicine, PO Box 4345, Christchurch, New Zealand; roger.mulder@chmeds.ac.nz sug: subj: Clinical Trials Mental Disorders Therapy Physicians Professional Practice Psychiatry Methods External Validity Internal Validity Medical Practice, Evidence-Based Psychotherapy Reproducibility of Results ab: OBJECTIVE: To discuss the extent to which the results of randomized controlled trials (RCTs) in psychiatry can be generalized to clinical practice. METHOD: Threats to internal and external validity in psychiatric RCTs are reviewed. RESULTS: Threats to internal validity increase the possibility of bias. Psychiatric RCTs have problems with small samples, arbitrary definitions of caseness, disparate definitions of outcome and high spontaneous recovery rates. Particular issues arise in psychotherapy RCTs. Threats to external validity reduce the extent to which the results of a RCT produce a correct basis for generalization to other circumstances. These include high rates of comorbidity and sub syndromal pathology in normal clinical practice, manual-based treatment protocols and varying definitions of successful treatment. CONCLUSIONS: Randomized controlled trials remain the most robust design to investigate the effectiveness of treatments. They should be applied to important clinical questions; and carried out, as far as possible, with typical patients in the clinical conditions in which the treatment is likely to be used. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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