Clinical trials: More to learn than the results

[摘要] Randomized controlled trials provide the highest level of evidence forthe way we practice medicine, particularly in our choice of treatment.But the results of these trials often have limited applicability to specifi c patients, asparticipants in clinical trials are not exactly the same as the patients who show up inour offi ces. Even beyond the exclusion and inclusion criteria of clinical trials, otherfactors distinguish patient outcomes in our practices from those in trials. Patients inwell-conducted trials are monitored closely, and the data are meticulously collected.While we all like to think we follow our patients carefully and appropriately, I am periodically reminded how I have failed to recognize or record a specifi c detail. Smarterelectronic medical records can help us do this better in routine practice. For now, theforced discipline of data collection in a well-conducted trial can provide a uniquetreasure trove of information on disease course and patient outcomes that is harderto generate in real-world practice and much harder for each of us to accurately recall.Clinical trials can provide us with insights beyond the drugs being tested.

[学科分类] 卫生学