By Brian S. Everitt, Simon Wessely
King's collage, London, united kingdom. Explains the randomized managed trial for psychological future health pros. Describes the differing kinds of trials, find out how to examine the implications, and the way to behavior a tribulation. additionally discusses why trials are priceless and why they're the way in which of figuring out if a selected remedy is efficacious. Softcover.
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Additional resources for Clinical trials in psychiatry
But the argument generally made for such a study is that conclusive evidence that the new combined therapeutic approach is indeed beneficial in practice is adequate for its adoption even when the mechanism of the effect is unknown. ’ and aim to measure effectiveness, the benefit a treatment produces in routine clinical practice. In contrast, what is known as an explanatory trial attempts to measure treatment efficacy, the benefit a treatment produces under ideal conditions. We shall return to the implications of this pragmatic/explanatory division for psychiatric trials, in later chapters.
The problem is that when we come to study the results from a given period of treatment for a given patient, the results may reflect not only the effect of the current treatment, but also the effect of the previous treatment. The disentangling of one effect from another may be extremely difficult. In an attempt to deal with this potential difficulty, crossover designs almost always include a ‘wash out’ interval between the times participants are receiving the two treatments. But one can never be sure this wash out period is effective, and it is also exceedingly difficult to arrange such an interval for anything other than a drug trial.
It could be argued that there are many circumstances in which it is unethical not to do a randomized clinical trial; this argument is enthusiastically supported by the writers of this book, although we recognize that conducting trials that of sufficiently poor quality that they cannot make a meaningful contribution to medical knowledge, is in itself, unethical. The truth is that many of our cherished interventions, or so called ‘best practices’ have never been rigorously evaluated. There is a very real risk that many things that we do to our patients, or recommend that they do for themselves, may in the fullness of time be found seriously wanting.
Clinical trials in psychiatry by Brian S. Everitt, Simon Wessely