Minimisation: the platinum standard for trials?

BMJ 1998;317:362-363 ( 8 August )

Editorials

Minimisation: the platinum standard for trials?

Randomisation doesn't guarantee similarity of groups; minimisation does

The first 150 words of the full text of this article appear below.

When we have to decide which of two drugs, interventions, or management strategies is the better, the most secure evidenceis generally obtained from a randomised controlled trial. The primary objective of randomisation is to ensure that all otherfactors that might influence the outcome will be equally representedin the two groups, leaving the treatment under test as the onlydissimilarity. Any difference in outcome can then be attributedto the treatment effect. But how realistic is this assumptionin practice?

When published a randomised trial typically includes a table listing all the prior factors known actually or possibly to influenceoutcome. The average age and its distribution in each group andthe proportion of men and women usually head the list, followedby other likely determinants of outcome. In the case of heartdisease these will probably include details of left ventricularfunction; the proportions in each group . . . [Full text of this article]

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