Do doctors have a duty to take part in pragmatic randomised trials?

Doctors require knowledge of the potential benefits and harms of different treatment options to inform clinical decision making. Patients also require this information to make an informed choice between different treatment options. This knowledge base is generated from robust clinical research such as randomised controlled trials. For this knowledge base to advance, doctors and patients must be willing to take part in studies. Randomised trials are the most rigorous way to evaluate effectiveness because they aim to compare interventions fairly. Many trials have shown that treatments that were thought to be beneficial before rigorous testing were actually of minimal benefit or harmful (for example, oxygen therapy in acute myocardial infarction). Pragmatic randomised trials evaluate treatments as they are delivered in routine clinical practice, aim to answer clinically relevant questions, and directly inform clinical decision making. Trials can occur only if doctors and patients take part—without their involvement, this knowledge would not exist. Doctors routinely use, and their knowledge benefits directly from, information gathered from trials (for example, when using evidence based clinical guidelines).