ReviewComplexity and contradiction in clinical trial research☆
References (216)
- et al.
The application of therapeutictrial principles to improve the design of epidemiologic research: a case-control study suggesting that anticoagulants reduce mortality in patients with myocardial infarction
J Chronic Dis
(1981) - et al.
Anticoagulants in acute myocardial infarction: the failure of anticoagulants to alter mortality in a randomized series
Am Heart J
(1966) - et al.
Long-term anticoagulant therapy after myocardial infarction
Lancet
(1962) Effect of propranolol in myocardial infarction
Lancet
(1965)- et al.
Effect on mortality of metoprolol in acute myocardial infarction
Lancet
(1981) - et al.
Protective effect of propranolol in threatened myocardial infarction
Lancet
(1978) - et al.
A controlled trial of propranolol in acute myocardial infarction
Lancet
(1966) - et al.
Absence of prophylactic effect of propranolol in myocardial infarction
Lancet
(1966) Trial of dipyridamole-aspirin in recurring venous thrombosis
Lancet
(1980)- et al.
A controlled trial of intramuscular lidocaine in the prevention of premature ventricular contractions: associations with acute myocardial infarction
Am Heart J
(1976)
Lignocaine given prophylactically to patients with acute myocardial infarction
Lancet
Trial of combined intramuscular and intravenous lignocaine in prophylaxis of ventricular tachyarrhythmias
Lancet
Controlled trial of lignocaine in prophylaxis of ventricular arrhythmias complicating myocardial infarction
Lancet
Reduction of sudden deaths after myocardial infarction (letter)
Lancet
Efficacy of low-dose heparin in prevention of extensive deep-vein thrombosis in patients undergoing total-hip replacement
Lancet
Failure of low-dose heparin to prevent deep-vein thrombosis after hip-replacement arthroplasty
Lancet
Controlled trial of streptokinase and heparin in acute myocardial infarction
Lancet
Australian multi-centre trial of streptokinase in acute myocardial infarction
Lancet
Cholesterol hydrochloride in hypercholesterolemic patients—effect on serum cholesterol and mortality
J Chronic Dis
Effect of combined clofibrate-nicotinic acid treatment in ischemic heart disease
Atherosclerosis
Effect of coronary bypass surgery on longevity in high and low risk patients
Oral disopyramide for the prevention of arrhythmias in patients with acute myocardial infarction admitted to open wards
Lancet
Oral disopyramide in prophylaxis of arrhythmias, following myocardial infarction
Lancet
Randomised placebo-controlled trial comparing oxprenolol with disopyramide phosphate immediate treatment of suspected myocardial infarction
Lancet
Intravenous and oral disopyramide after myocardial infarction
Lancet
The field trial: some thoughts on the indispensable ordeal
Bull NY Acad Med
An additional basic science for clinical medicine. II. The limitations of randomized trials
Ann Intern Med
Effect of sodium nitroprusside on mortality in acute myocardial infarction
N Engl J Med
Effect of short-term infusion of sodium nitroprusside on mortality rate in acute myocardial infarction complicated by left ventricular failure
N Engl J Med
Anticoagulant therapy after acute myocardial infarction
Report to the Medical Research Council
Anticoagulants in acute myocardial infarction. Results of a cooperative clinical trial
JAMA
Heparin administration after acute myocardial infarction
N Engl J Med
Heparin in the prevention of deep vein thrombosis after myocardial infarction
Br Med J
A double-blind trial of long-term anticoagulant treatment after myocardial infarction
Acta Med Scand
A double-blind trial to assess long-term oral anticoagulant therapy in elderly patients after myocardial infarction
Lancet
Double-blind trial of long-term anticoagulant treatment after myocardial infarction
Acta Med Scand
Long-term anticoagulant therapy after myocardial infarction
Long-term anticoagulant therapy after myocardial infarction
Can Med Assoc J
A double-blind study of dicumarol prophylaxis in coronary heart disease
Acta Med Scand
A controlled trial of long-term treatment with anticoagulants after myocardial infarction in 412 male patients
Med J Aust
Prevention of recurrences of myocardial infarction
A double-blind trial of metoprolol in acute myocardial infarction
II. Design of the study
Acta Med Scand
Randomized trial comparing propranolol with atenolol in immediate treatment of suspected myocardial infarction
Br Med J
Practolol in acute myocardial infarction
Acta Med Scand
Trial of propranolol in acute myocardial infarction
Br Med J
Propranolol in acute myocardial infarction
Alprenolol in acute myocardial infarction: double-blind trial
NZ Med J
Five-year findings of the hypertension detection and follow-up program. II. Mortality by race, sex and age
JAMA
Cited by (89)
The role of randomized controlled trials, registries, observational databases in evaluating new interventions
2023, Best Practice and Research: Clinical HaematologyGeriatric pharmacotherapy: Appraising new drugs for neurologic disorders in older patients
2019, Handbook of Clinical NeurologyCitation Excerpt :This is not the case because the methodology may have been flawed, which explains why RCTs conducted on the very same drug often result in contradictory findings. The reasons for this are many: baseline differences in the population available for study (e.g., age, ethnicity, type of disorder), discrepancies in eligibility criteria, deficiencies in randomization procedures, and undisclosed errors in trials that bias the observed outcomes (Horwitz, 1987). A second unwarranted assumption is that, once on the market, the drug will be used in the same way and for the same target symptoms and in the same populations as in the original trials.
Randomized trials and evidence in medicine: A commentary on Deaton and Cartwright
2018, Social Science and MedicineHeart disease diagnosis based on mediative fuzzy logic
2018, Artificial Intelligence in MedicineCitation Excerpt :In medicine, information from experiments can be somewhat inconsistent because patients being might respond different to some experimental medication. The contradictory results from multiple clinical trials are attributed either to methodological deficiencies in the design of one of the trials or to small sample sizes [19]. After the introduction of mediative fuzzy logic, a number of works have demonstrated the benefits of its use [18,20–22].
Randomized controlled trials and real life studies. Approaches and methodologies: A clinical point of view.
2014, Pulmonary Pharmacology and TherapeuticsCitation Excerpt :This may minimizing any further advantages from the trial intervention and result in underestimation of preventive effects [22,55,56]. Interestingly, differences in patient selection criteria between RCTs may produce conflicting results for a given outcome [10,57]. For instance, there are contradictory data on the protective efficacy of bacillus Calmette–Guérin vaccine in the prevention of tuberculosis, probably linked to various diagnostic criteria used in different settings [10,58,59].
- ☆
This work was supported in part by the Robert Wood Johnson Foundation Clinical Strategies Grant 6309.
- 1
Dr. Horwitz is a Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine.