Editorials

More randomised controlled studies in speech and language therapy

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7314.645 (Published 22 September 2001) Cite this as: BMJ 2001;323:645

Complex behavioural interventions can be evaluated

  1. Paul Carding, senior lecturer in voice pathology,
  2. Robert Hillman, director of the voice and speech laboratory
  1. Freeman Hospital, Newcastle University, Newcastle upon Tyne NE7 7DN
  2. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Cambridge, MA 02114, USA

    Papers p 658

    Randomised controlled trials remain the most widely accepted way of evaluating new treatments. Clinical services such as speech and language therapy, however, have been particularly reluctant to produce randomised controlled trials as evidence of efficacy of treatment. 1 2 An evidence base is emerging for the efficacy of a number of speech and language therapy interventions, especially in dysphasia, stammering, laryngectomy, and dysphonia.3 Most interventions, however, have been evaluated by uncontrolled before and after comparisons. One of the first randomised controlled trials in speech and language therapy to evaluate voice therapy in dysphonia appears in this issue.4 This trial shows that it is possible to design and carry out randomised controlled trials to examine complex behavioural interventions.

    Randomised controlled studies are difficult to apply in some areas5; the limitations of such trials in general medicine, surgery, and behavioural therapies are well documented. 2 6 7 Researchers in speech and language therapy have been reluctant to use randomised controlled designs because of the complexity and individuality of human communication …

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