Intended for healthcare professionals


Inappropriateness of randomised trials for complex phenomena

BMJ 2005; 330 doi: (Published 06 January 2005) Cite this as: BMJ 2005;330:95

Author's reply

  1. Andrew Kotaska, resident (
  1. Department of Obstetrics and Gynaecology, University of British Columbia, Women's Hospital, Vancouver, BC, Canada V6H 3V5

EDITOR—Boutron et al misquote a summary point to suggest that all complex procedures are not amenable to randomised investigation. They note that randomisation within a system of procedural excellence (not in 121 centres in 26 countries) can be a useful investigational tool. This certainly is the case; however, one must remember that procedural excellence always remains in evolution.

Wide variations in confidence …

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