From therapeutic trials to current practice.
Ideally, there is continuous interaction between clinical reality and the methods of controlled clinical trials. The design of a proper trial ought to reflect the physician's and especially the patient's point of view, and conversely a familiarity with clinical trials improves the methods of daily practice. In other words, every methodological principle is rooted in clinical practice. Some examples are: randomisation (with constructive doubt as its practical equivalent), independence (a healthy mistrust of drug companies), informed consent (sharing uncertainty with patients), type I error (no false optimism after a single trial), type II error (no false pessimism after a single trial), choosing the right measure of outcome (relevance outweighs precision), the intention-to-treat principle (pragmatic analysis), and the dangers of subgroup analysis (the "my-last-patient syndrome").
van Gijn
J
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D004345:Drug Industry; D006801:Humans; D007258:Informed Consent; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012109:Research Support as Topic; D016896:Treatment Outcome