BMJ  2005;330:792 (2 April), doi:10.1136/bmj.330.7494.792

Letter

Need for expertise based randomised controlled trials

Surgical research shares many similarities with psychotherapy research

The first 100% of the full text of this article appears below.

EDITOR—Of course the expertise based randomised trial, mooted for surgical procedures by Devereaux et al,¹ is the norm in psychotherapy research when comparing two different psychotherapies. A similar debate on the interpretation of such trials occurred in the psychotherapy literature.²

Research in surgery and psychotherapy share other similarities beyond having to account for practitioner expertise. There is the issue of blindness—hard to achieve for both patient and doctor in these disciplines—as well as the "why test it, it's obvious it makes a difference" argument. Both disciplines could learn from each other about the design and analysis of clinical research.

Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1, New Zealand s.hatcher@auckland.ac.nz

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Competing interests: None declared.

1. Devereaux PJ, Bhandari M, Clarke M, Montori VM, Cook DJ, Yusuf S, et al. Need for expertise based randomised controlled trials. BMJ 2005;330: 88. (8 January.)[Free Full Text]
2. Barber JP, Foltz C, Crits-Christoph P, Chittams J. Therapists' adherence and competence and treatment discrimination in the NIDA collaborative cocaine treatment study. J Clin Psychol 2004;60: 29-41.[Medline]

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Need for expertise based randomised controlled trials

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