ReviewNeurosurgical review2021
Randomized controlled trials-a critical re-appraisal.
Review in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 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
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Powered vs. manual toothbrushes in fixed orthodontic patients: a systematic review and meta-analysis.European journal of orthodontics · 2026Pooled it
- The Effectiveness of Intraosseous Basivertebral Nerve Radiofrequency Ablation for the Treatment of Vertebrogenic Low Back Pain: An Updated Systematic Review with Single-Arm Meta-analysis.Pain medicine (Malden, Mass.) · 2022Pooled it
- The fragility index: how robust are the outcomes of head and neck cancer randomised, controlled trials?The Journal of laryngology and otology · 2024Trial
- A literature review and reflection on clinical trials: current challenges, future directions, and potential strategies to overcome practical barriers.AME clinical trials review · 2026Article
- Factors associated with enrollment in a randomized clinical trial of docosahexaenoic supplementation in toddlers born preterm.Clinical trials (London, England) · 2026Article
- Research Trends and Hotspots in Mendelian Randomization Studies of Liver Diseases: A Bibliometric and Visualization Analysis.Hepatic medicine : evidence and research · 2026Review
- State-of-the-Art on Model-Informed Drug Development Approaches for Pediatric Rare Diseases.CPT: pharmacometrics & systems pharmacology · 2025Review
- The application of mendelian randomization in cancer research: a bibliometric analysis.Discover oncology · 2025Article
- Navigating Real-World Randomized Clinical Trials: The 'Parents as Teachers' Experience.International journal of environmental research and public health · 2024Article
- Mendelian randomization analysis reveals causal associations of serum metabolites with sepsis and 28-day mortality.Scientific reports · 2024Article
- [Research advances of real world study in the field of chronic wound].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2022Article
- Sick Leave and Costs in Active Workers with Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study.Open access rheumatology : research and reviews · 2022Article
- Paracetamol: A Review of Guideline Recommendations.Journal of clinical medicine · 2021Review
- What Does Quality of Care Mean in Lower-Grade Glioma Patients: A Precision Molecular-Based Management of the Tumor or an Individualized Medicine Centered on Patient's Choices?Frontiers in oncology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Randomized controlled trials (RCTs) are considered to represent the gold standard of scientific studies and paved the way for evidence-based medicine (EBM). Besides the initial aim to improve the quality of patient care, EBM is used in the meanwhile for political and economic decision-making and legal issues as well. A review of the literature was performed, followed by a search using links and references of the detected articles. Additionally, homepages for German institutions of public health were screened. Substantial limitations of RCTs and EBM health care could be identified. Based on the selected literature, 80% of the medical treatments have low evidence. RCTs are expensive and are mainly performed by the industry nowadays. A publication bias for positive results exists. Some RCTs are of low external validity. Many studies have a low fragility index. Nonetheless, negative RCTs could be of benefit for the patients. The results of RCTs, gained in a distinct patient population, are partially generalized. RCTs should be analyzed critically before adopting the results to daily clinical routine. It is not really justified to use RCTs and EBM for political and economic decision-making and legal issues as seen today.
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.