The randomized clinical trial (RCT) is a powerful experimental design that when properly executed produces generalizable results. Conducting a RCT becomes complex when technical skills are required. Without requisite skills, a RCT may yield misleading results, an elegant RCT unwittingly generating spurious results due to technical inexperience. This pitfall is applicable to procedures used to e...

Radiation-induced skin reactions occur in 80-90% of breast cancer patients by completion of treatment [1]. To date, there is no standard treatment for radiation-induced skin reactions. In a recent survey, Kumar, et al. [2] found that 50% of responding departments in Australia and New Zealand based their skin care policy on anecdotal evidence. This situation is not limited to Australasia; skin c...

PURPOSE OF REVIEW We review the current state of evidence-based prevention strategies for reducing sexual transmission of HIV. The combined programmatic and scientific efforts through 2008 to reduce sexual transmission of HIV have failed to reduce substantially the global pandemic. RECENT FINDINGS Prevention interventions to reduce HIV infection target behavioral, biomedical, and structural r...

There is a general agreement that before a therapy can be accepted into widespread clinical use, demonstration of efficacy in randomized clinical trials (RCTs) is absolutely necessary. There are, however, a growing number of experts who believe that demonstration of RCT efficacy might not be a sufficient basis for widespread acceptance.1 RCTs may not enroll subjects representative of patients i...

IMPORTANCE Reanalyses of randomized clinical trial (RCT) data may help the scientific community assess the validity of reported trial results. OBJECTIVES To identify published reanalyses of RCT data, to characterize methodological and other differences between the original trial and reanalysis, to evaluate the independence of authors performing the reanalyses, and to assess whether the reanal...

There are a number of difficulties in the conduct of randomized trials in the critically ill. These include difficulties in the definition of diseases and syndromes, a heterogenous population of patients undergoing a variety of therapeutic interventions, and outcomes that may not be able to discriminate between beneficial and risky therapies. Following a brief description of different randomize...

To evaluate the beneficial and adverse effects of breviscapine injection in combination with Western medicine on the treatment of patients with angina pectoris. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, the China National Knowledge Infrastructure, the Wanfang Database, the Chongqing VIP Information Database and the China Biomedical Database wer...

Comparative effectiveness research has received considerable attention in recent years and has been accompanied by controversy, especially in response to the 2013 Office for Human Research Protections (OHRP) investigation of the Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial (SUPPORT)—a randomized trial of 2 contrasting oxygen saturation settings in mechanical ventilation of...

PURPOSE/OBJECTIVES To describe techniques to overcome challenges of collaborating with multiple clinical sites and participants to enhance recruitment and retention for cancer symptom management randomized clinical trials (RCTs). DATA SOURCES Personal experiences and publications related to recruitment and retention of sites and participants in RCTs, which were found by searching MEDLINE, CIN...

Common cancers may arise from several different mutations, and each causative mutation may require different treatment approaches. There are also several mechanisms by which malignancies may become resistant to therapy, and each mechanism will also require a different therapeutic strategy. Hence, the paradigm of devising therapies based on tumor type is suboptimal. Each common malignancy may no...