The clinical utility of randomized controlled trials.
OBJECTIVE
Efficacy studies using randomized controlled trials (RCTs), on which empirically supported treatments are based, are often rejected as having little if any relevance to clinical practice. RCTs are faulted for allegedly excluding poor prognosis patients and therapists and treatments that are unrepresentative of clinical practice.


METHODS
Evidence on the generalizability of findings from RCTs to diverse patient populations, different therapists, and varied clinical settings is critically evaluated.


RESULTS
Existing research indicates that RCTs commonly include patients with multiple problems and levels of disturbance as severe as patients in clinical settings.


CONCLUSIONS
The applicability of the findings of RCTs to clinical practice will be a changing function of the nature of the particular study and clinical setting to which the results are to be generalized. Future research should address the clinical utility of the findings of efficacy studies across different patient populations, therapists, and treatment methods.
Wilson
G T
GT
Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey 08855-0819, USA.
D002032:Bulimia / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome