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Clinical application of findings of clinical trials and systematic reviews

Correspondence to:
Correspondence to:
Dr Robert G Newcombe, Department of Epidemiology, Statistics and Public Health, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, UK;
newcombe@cf.ac.uk

Keywords: clinical trials; systematic reviews; statistical models; meta-analysis; random effect models

The late Professor Archie Cochrane is probably best remembered for enunciating several key principles which are now recognised as fundamental in all areas of clinical practice and associated research. He insisted on the central role of the randomised controlled trial (RCT) in seeking to evaluate the efficacy of interventions, particularly (though not exclusively) in the clinical context. Since the resources available will never be limitless, efficiency is a key issue as well as effectiveness. Furthermore, Cochrane advocated more systematic application of the findings of research. Several trials bearing on the same clinical issue may have yielded divergent findings—what is the clinician then to do? He argued that it is incumbent on the profession to assemble systematically the evidence bearing on an issue. Systematic review uses objective, reproducible criteria to determine which studies yield the most reliable information. The results of the selected studies are then . . . [Full text of this article]

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