Everything in Moderation

Grossman and MacKenzie’s article suggests the need for a change in the reputation of randomized controlled trials as the most effective and reliable form of study. Its appearance as superior has resulted in a highly prevalent desire amongst researchers to use them almost exclusively (taking advantage of the automatic credibility an RTC can lend their work). This has had the unfortunate effect of blinding researchers and others to both the shortcomings of evidence-based medicine, and the merits of other methods of research such as observation-based studies. The article suggests that public health interventions in particular would benefit from increased research of the latter type, since many of these issues lack the funding to go through expensive RCTs, and receive much less attention than they deserve largely due to lacking this ‘gold standard’ label of credibility. Our overwhelming concern with reducing bias in medical research and practices has caused us to fanaticize a form of study which appears (or used to) to do so, but ultimately result in less effective results which are in fact biased in a whole new direction. Aside from the flaws within RCTs themselves, it is dangerous that we automatically place our trust in any study based upon them, regardless of their actual content of results. Once again, we seem eager to place our faith in an invisible force promising to deliver truth and accuracy, and almost blind ourselves to any evidence which may alter this vision once we hold it.

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