ArticleJournal of clinical epidemiology2022
Identification of threshold for large (dramatic) effects that would obviate randomized trials is not possible.
Article in Journal of clinical epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis 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
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- What is the probability that higher versus lower quality of evidence represents true effects estimates?Journal of evaluation in clinical practice · 2025Article
- Availability of evidence and comparative effectiveness for surgical versus drug interventions: an overview of systematic reviews.medRxiv : the preprint server for health sciences · 2023Article
- Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.Journal of clinical epidemiology · 2022Article
- Published correlational effect sizes in social and developmental psychology.Royal Society open science · 2022Article
- Assessing the quality of evidence on safety: specifications for application and suggestions for adaptions of the GRADE-criteria in the context of preparing a list of potentially inappropriate medications for older adults.BMC medical research methodology · 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
4 authors.
Funding
Abstract
objectiveTo analyze distribution of "dramatic", large treatment effects. STUDY DESIGN &
settingPareto distribution modeling of previously reported cohorts of 3,486 randomized trials (RCTs) that enrolled 1,532,459 patients and 730 non-randomized studies (NRS) enrolling 1,650,658 patients.
resultsWe calculated the Pareto α parameter, which determines the tail of the distribution for various starting points of distribution [odds ratio
conclusionsThe effects sizes observed in RCTs and NRS considerably overlap. Large effects are rare and there is no clear threshold for dramatic effects that would obviate future RCTs.
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.