January 24, 2018

Philosophiae naturalis

Studying Studies: Part III – the motivation for observational studies

If randomized-controlled trials are considered the gold standard for establishing reliable knowledge, why do we see so many observational studies in public health?

by Peter Attia

Read Time 11 minutes

Motivation for observational studies
The randomized-controlled trial (RCT) is often considered the gold standard to determine the risk or benefit of a particular intervention. By randomly allocating alike participants into a treatment or control group, much of the bias encountered in observational studies is reduced substantially.9RCTs are not immune to bias. Not even close. RCTs are prone to many of the same biases that seep into observational studies. There are additional biases that RCTs attract because of the experimental and randomized approach, performance bias being a prime example. Investigators can more confidently assess and control variables. In short, an RCT makes it possible to distinguish the relationship between cause and effect.

Image credit: PrevMedFellow (Own work) [CC BY-SA 3.0], via Wikimedia Commons.Figure 1. Flow diagram of the progress through the phases of a parallel randomised trial of two groups, modified from the CONSORT (Consolidated Standards of Reporti...

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