title: [Clinical trials--methodological gold standard or naive reductionism?].
abstract: The methodological concept of the randomized controlled clinical trial is a relatively recent invention. It is widely accepted to be the only means of conclusively establishing a cause effect relationship between a given therapeutic intervention and an observed outcome. There are, however, numerous pitfalls. Ethical concerns and/or practical problems can seriously affect both proper randomisation as well as the use of a placebo treatment as the control intervention. Sometimes blinding of the patients or the therapist may be difficult or even impossible, depending on the availability of a similar treatment without the specific therapeutic effect, whereas a satisfactory investigator blinding can be achieved in most instances. Practical problems can be minimised by adapting the trial design to the given clinical situation. The fact that a number of drawbacks exist, must, however, not be used as an argument to abstain from performing such studies--simply because there is no better alternative.
authors.affiliation: Postgraduate Medical School, University of Exeter, United Kingdom.
authors.forename: E
authors.initials: E
authors.lastname: Ernst
authors.forename: K L
authors.initials: KL
authors.lastname: Resch
mesh_terms: D015982:Bias; D006801:Humans; D010686:Philosophy, Medical; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000706:statistics & numerical data*; D012016:Reference Values; D016896:Treatment Outcome
vernacular_title: "Clinical trials"--Methodischer Goldstandard oder naiver Reduktionismus?