Randomised Controlled Trials Essay

An annotated bibliography is a catalogue of citations to books, documents and articles with the purpose of the annotation being to inform the reader of the precision, relevance and quality of the sources cited (Davis, 2009). Evidence based practice enables health care professionals to effectively use current verification during the decision-making procedure (Sacket et al 2000). Healthcare professionals use a hierarchy of evidence as a guide to define the reliability and importance of the evidence based research; with the evidence that is founded further upon

Everybody has their own methods for writing; however, I believe there is always room for improvement. Chapter 3 in Everyone’s an Author has shown me that writing involves processes that need to be mastered through constant practice. It also revealed helpful tips on how to develop writing processes that can help write effective papers.

Research is an important part of finding the appropriate CAM therapy that will help the patient’s symptoms. The information that is obtained during research could be full of opinions and not facts. Since we want factual information instead of opinions it is important that we are sure the information we are looking at is a reliable and credible source.

While this structure provides a starting point for the critique of evidence strength, the prudent evaluation and, subsequent, translation into practice guidelines requires further consideration (Greenhalgh, 2010). Research can be scrutinized into measures of quality. John Hopkins Hospital grades evidence on a high to low scale, A through C, based on criteria including consistency of results, reproducibility of findings, sample size of study, level of study control, organizational design, and expert opinion (Newhouse, Dearholt, Poe, Pugh, & White, 2005). Using this evaluation tool, an A score would result in a recommendation for clinical practice while a score of C should alert the clinician to a low quality of research and should not be incorporated into practice guidelines (Newhouse et al., 2005).

The author considers the simplest way of finding out best practice is by using guidelines. According to Field & Lohr (1992) guidelines are “systematic developed statements to assist practitioners and patients decisions for specific clinical circumstances.” Evidence is always current and a generous collection of many different systematic research reviews with multiple random control trials are available (AGREE, 2000). These types of trials are graded at the top level of hierarchy (Guyatt et al 2002).Nevertheless in contrast Devereaux and Yusuf (2005) argue that top level hierarchy is not a guaranteed deviation from the truth in randomized trials. The clinical guidance used is the National Institute of Clinical Guidance (NICE 2009) is based in the author’s homeland and is an independent organisation responsible for providing guidelines. The ethos behind NICE (2009) is to promote and prevent poor health nationally involving the public, health professionals and patients in the process (NICE 2009).

Evidence based practice is the incorporation of individual clinical expertise with best research evidence and patient values and expectations. Health care decision of individual patients should be based on best available research evidence. A health decision made from a sound research evidence has the potential to ensure best practice and reduce variations in health care delivery. In health science, an ever increasing plethora of studies being published and is challenging for clinicians to keep up with the literature. Integrating research into practice is time consuming and need methods for easy access to such evidences for busy clinicians. Indeed, clinical decision should be based on the latest research evidence. Systematic reviews and meta-analyses summarize the research evidence, which is generally the best form of evidence, thereby making the available evidence more accessible to decision makers and are positioned

While research has long paralleled medicine, the use of strong research evidence as the basis for clinical action is more recent (Houser, 2015). The historically accepted hierarchy of evidence separates evidence into levels of trust, from highest to lowest (Greenhalgh, 2010):

The study selected by this author centers around ethical and oversight issues concerning standard of care interventions received by participants in research studies. So as to address recently arisen concerns regarding key aspects of regulation and oversight of standard of care interventions executed during trials, the office for human research protections (OHRP) solicited comments from experts on what has been termed as “Draft Guidance” (Institute of Medicine [IOM], 2015, pp. 1-3).

Third, professionals who are given new, unusual, and unfamiliar situations may have trouble with accessing and retrieving new evidence (Rousseau & Gunia, 2016). Among these main issues, other criticisms that have arose since its beginning include the effectiveness of treatments and evidence. The first criticism states that evidence-based practice has only one approach, which is only one approach for all people. This is an error within itself and in practice because not all people have the same illnesses and not all people respond to one treatment in the same way (Rousseau & Gunia, 2016). Another criticism is that the practice mainly relies on randomly controlled trials (RCTs), which involves randomly allocating one or other of the different treatments under study. This may affect the patient solemnly on the fact the patient may be receiving only one form of treatment that may increase or decrease effectiveness against their illness, or may be receiving a treatment that has not fully researched and may be excessively failing (Rousseau & Gunia, 2016). Evidence-based practice may also rely heavily on human judgement, which may affect a practitioner 's decision on what type of evidence to use before conducting practice on a patient. Their judgement may not be very stable and acceptable, thus causing various problems in their practice and

Translational research is a complex subject that can often be misunderstood by many people. The term can be defined as transcribing research data into clinical practice (Mulnard, 2011). Translational research is frequently summarized with the phrase “bench-to-bedside,” which essentially means that analytics from the research bench are tested and applied to new pharmaceuticals and devices for patients (Mulnard, 2011). Ultimately, the research stimulates the APRN to evaluate the learned science and cultivate new solutions to problems.

In their research, Cohen, et al. (2001) and colleagues suggest that randomized controlled trials conducted in research settings, may not provide the whole picture about the most

The author believes that biomedical research is the way of better understanding medicine and without randomized clinical trials the field of medicine will have insufficient information. He argues that randomized clinical trials are the most scientifically sound and ethically correct means of evaluating new therapies. The belief of a physician being unethical when running randomized clinical trials is rejected by this article because previous trials on patients can have a better outcome on future patients. This article stresses that randomized clinical trials must be carefully designed that has an intended purpose of gathering data to improve the wellbeing of patients. If the patient is to endure a clinical trial he/she must be properly informed of the risks of the trial and the health of the patient should be high priority. Overall this article explains the importance of randomized clinical trials and debunks the idea of randomized clinical trials as being unethical. This article uses a utilitarian point of view and gives reasons why these trials can be in the best interests for both the patient and society.

Both clinicians who are enquiring clinical questions and researchers who are conducting in-depth searches for systematic reviews come across a few

For example, Vedula (2012) notes that FDA guidelines state pharmaceutical companies can use peer-reviewed articles to publicize evidence of a drug’s effectiveness for off-label uses, as long as a number of conditions are met—perhaps the most essential of which is that “the information disseminated must not be false or misleading.” However, Vedula continues, there is no unyielding regulation that all research findings have to be published. Therefore, a company can still choose to selectively disseminate favorable findings. His article concludes that there is now a copious amount of evidence that suggests selective reporting of study results, based on the strength and direction of findings, is performed extensively by the pharmaceutical industry.

It is now accepted worldwide that before a drug is brought into routine use its efficacy, safety, and the balance between two need to be formally demonstrated. The efficacy of new drugs nowadays is almost invariably established with a technique known as ‘randomized controlled trial’.