Randomized controlled trials in psychiatry
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Psychiatr Pol 2012;46(1):109-121
In the past twenty years, evidence based medicine (EBM) has become a dominant paradigm of the contemporary medical practice. Since the emergence of the significant article by Geddes and Harrison in 1997, this doctrine has become part of psychiatry too. According to the rules of EBM, the most valuable clinical data comes from randomized-controlled trials (RCT). Nevertheless there are numerous researchers who point out at some limitations making RCT less valid in psychiatry than in other medical disciplines. The authors of this paper reviewed the available literature on the place of RCT in psychiatry and subsequently presented current opinions about the reliability of those trials, as well as highlighted the possible solutions of potential controversies. We suggest that in spite of the limitations mentioned above, RCT remains the most valuable research strategy in psychiatry. Most of the obstacles do not differ significantly from the problems seen in other medical fields. There are also known methods of improving methodology of RCT (such as recruiting larger groups of patients or performing expertise-based RCT).
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