BMJ  2005;330 (8 January), doi:10.1136/bmj.330.7482.0-a

Expertise based trials may be the way forward for evaluating surgical interventions

Although a randomised controlled trial is the best study design for evaluating pharmacological interventions, scepticism about whether it is best in non-pharmacological interventions (such as surgery) remains. Devereaux and colleagues (p 88) propose an alternative: the expertise based randomised controlled trial, in which participants are randomised to clinicians with expertise in intervention A or intervention B. They argue that increased use of the expertise based design will enhance the validity, applicability, feasibility, and ethical integrity of randomised controlled trials in surgery and other non-pharmacological areas.

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Need for expertise based randomised controlled trials

P J Devereaux, Mohit Bhandari, Mike Clarke, Victor M Montori, Deborah J Cook, Salim Yusuf, David L Sackett, Claudio S Cinà, S D Walter, Brian Haynes, Holger J Schünemann, Geoffrey R Norman, and Gordon H Guyatt
BMJ 2005 330: 88. [Extract] [Full Text] [PDF]