ReviewJournal of the American College of Cardiology2020
Randomized Trials Versus Common Sense and Clinical Observation: JACC Review Topic of the Week.
Review in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Examining the empirical evidence for IDEAL 2b studies: the effects of preceding prospective collaborative cohort studies on the quality and impact of subsequent randomized controlled trials of surgical innovations - protocol for a systematic review and case-control analysis.BMJ surgery, interventions, & health technologies · 2022Pooled it
- Characteristics of Randomized Clinical Trials in Surgery From 2008 to 2020: A Systematic Review.JAMA network open · 2021Pooled it
- Cardiovascular Safety of Degarelix Versus Leuprolide in Patients With Prostate Cancer: The Primary Results of the PRONOUNCE Randomized Trial.Circulation · 2021Trial
- Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial.Lancet (London, England) · 2021Trial
- Trial
- Measuring Representativeness in Clinical Trials.Circulation · 2025Review
- Clinical decision making in healthcare: the importance of best evidence.Jornal vascular brasileiro · 2025Article
- Reevaluating Mask Effectiveness: Insights From Evidence-Based Medicine and Clinical Trials.Cureus · 2024Review
- Aversion to pragmatic randomised controlled trials: three survey experiments with clinicians and laypeople in the USA.BMJ open · 2024Article
- The role of early-phase trials and real-world evidence in drug development.Nature cardiovascular research · 2024Review
- Perspective on Intradiscal Therapies for Lumbar Discogenic Pain: State of the Science, Knowledge Gaps, and Imperatives for Clinical Adoption.Journal of pain research · 2024Article
- Clinical outcomes of automatic algorithms in cardiac resynchronization therapy: Systematic review and meta-analysis.Heart rhythm O2 · 2023Article
- Anakinra authorized to treat severe coronavirus disease 2019; Sepsis breakthrough or time to reflect?Frontiers in microbiology · 2023Article
- Matters Arising: Immortal time bias in the analysis of drug prescription trajectories.NPJ digital medicine · 2022Article
- The need for increased pragmatism in cardiovascular clinical trials.Nature reviews. Cardiology · 2022Review
- [Clinical and prognostic profile evolution of patients discharged from hospital due to heart failure in the first two decades of the 21st century. The INCA-Ex Registry].Atencion primaria · 2022Observational
- The principles of whole-hospital predictive analytics monitoring for clinical medicine originated in the neonatal ICU.NPJ digital medicine · 2022Review
- Natural cycles achieve better pregnancy outcomes than artificial cycles in non-PCOS women undergoing vitrified single-blastocyst transfer: a retrospective cohort study of 6840 cycles.Journal of assisted reproduction and genetics · 2022Article
- Impact of the COVID-19 Pandemic on Non-COVID-19 Clinical Trials.Journal of cardiovascular development and disease · 2022Article
- Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience.Open medicine (Warsaw, Poland) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Concerns about the external validity of traditional randomized clinical trials (RCTs), together with the widespread availability of real-world data and advanced data analytic tools, have led to claims that common sense and clinical observation, rather than RCTs, should be the preferred method to generate evidence to support clinical decision-making. However, over the past 4 decades, results from well-done RCTs have repeatedly contradicted practices supported by common sense and clinical observation. Common sense and clinical observation fail for several reasons: incomplete understanding of pathophysiology, biases and unmeasured confounding in observational research, and failure to understand risks and benefits of treatments within complex systems. Concerns about traditional RCT models are legitimate, but randomization remains a critical tool to understand the causal relationship between treatments and outcomes. Instead, development and promulgation of tools to apply randomization to real-world data are needed to build the best evidence base in cardiovascular medicine.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.