RCTs as a Requirement for Objectivity

In reading these articles about randomized control trials, I am struck by the significant amount of disagreement amongst the authors.  Grossman and Mackenzie state that the trial design should answer the experimental question and that there are some places that RCTs should be used (Grossman and MacKenzie, 526) – like in the case of phase III drug trials (ibid 531).  McGoey’s article seems to suggest that RCTs are not useful at all one of the reasons that she has given is that some patients are excluded because it would be unethical to include them due to the severity of their condition (McGoey, 70).  Personally, I tend to agree with Wolpert, that anti-depressants are effective and even if it is only the placebo effect that helps someone through that, at least it is still help.

As for the hierarchies that prioritize information coming out of RCTs over other types of studies, which is mentioned in both the McGoey and the Grossman and MacKenzie articles in reference to policy making in the U.S, the U.K., and Australia.  The propensity to demand evidence in order to make good decisions is one that has been long ingrained in the public consciousness after several horrifying debacles because of lack of objective evidence.  The RCT seems to provide a more objective standard than studies that rely on human observation (which has gotten us into trouble in the past).  While it might not be the most effective method it has proven to be one of the more objective.

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