[The principles in the evaluation of the efficacy of health and social interventions].
The 10 Cs are a reminder of the principles that should lead any evaluation of the efficacy (i.e. the capacity to attain the specific objectives, in case of health services better health outcomes) of any intervention. They are: 1. Comparison with other treatment; 2. Comparability of compared groups; 3. Comparability of data collection; 4. Completeness of collected outcomes; 5. Completeness of follow-up; 6. Consistency of treatments; 7. Casuality (consideration of); 8. Consistency of investigated patients with patients who are treated in daily practice; 9. Continuity of surveillance; 10. Costs. The paper describes the almost total lack of effective treatments and of methods to test their efficacy till the beginning of 1800 and the gradual raise of the randomised controlled trial as the gold standard method for such an evaluation. It explain the 10 Cs with analogies from a less emotionally loaded area, that of teaching methodologies. It deals with the value and limit of single case description and hints to the ethical problems of doing or not doing a controlled trial, using Semmelweis and Pap test examples.
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma. antonella.gigantesco@iss.it
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Gigantesco
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Morosini
D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods* / Q000592:standards*; D016032:Randomized Controlled Trials as Topic / Q000941:ethics