Difficulties in conducting a randomized controlled trial of health service interventions in intellectual disability: implications for evidence-based practice.

BACKGROUND: In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for eff...

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Publicado en:Journal of Intellectual Disability Research Vol. 46; no. 4; pp. 340 - 346
Autores principales: Oliver PC, Piachaud J, Done J, Regan A, Cooray S, Tyrer P
Formato: review Journal Article
Publicado: Wiley-Blackwell May2002
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Difficulties in conducting a randomized controlled trial of health service interventions in intellectual disability: implications for evidence-based practice.
      aug:
        au:
          Oliver PC
          Piachaud J
          Done J
          Regan A
          Cooray S
          Tyrer P
        affil: Research Associate in Intellectual Disability, Dept of Public Mental Health, Faculty of Medicine, Imperial College, Paterson Centre, 20 South Wharf Road, London W2 1PD, UK; p.oliver@ic.ac.uk
      sug:
        subj:
          Clinical Trials
          Intellectual Disability Therapy
          Community Mental Health Services Evaluation
          Research Ethics
          Research Methodology
      ab: BACKGROUND: In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains 'the transformation of learning disability practice in the past 30 years is 'enlightenment'.' This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which 'is now at last regarded as disenfranchising'. CONCLUSIONS: The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.
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        Journal Article
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    language: English
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