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Randomised health services studies

Hakama, Matti; Malila, Nea and Dillner, Joakim LU (2012) In International Journal of Cancer 131(12). p.2898-2902
Abstract
The randomised controlled (or clinical) trial (RCT) is recognized as the most valid among the study designs. The use of RCT in research is widespread and well formalised. In contrast, implementations of new methods and policies in routine health care are commonly lacking a formalised design, impairing the ability to evaluate and improve health care. Use of experimental designs in health care is possible at the implementation phase of clinical or preventive action or more broad process-of-care. We propose the terminology randomised health services studies (RHS) to denote the use of a randomised design with observations in routine health care, regardless of whether randomisation is done at individual, population or process level. In contrast... (More)
The randomised controlled (or clinical) trial (RCT) is recognized as the most valid among the study designs. The use of RCT in research is widespread and well formalised. In contrast, implementations of new methods and policies in routine health care are commonly lacking a formalised design, impairing the ability to evaluate and improve health care. Use of experimental designs in health care is possible at the implementation phase of clinical or preventive action or more broad process-of-care. We propose the terminology randomised health services studies (RHS) to denote the use of a randomised design with observations in routine health care, regardless of whether randomisation is done at individual, population or process level. In contrast to RCT, the RHS should be based on the same regulative actions, funding mechanisms and ethical framework as routine health care itself. This commentary discusses the different basis, practicalities, and formalities that distinguish the RHS from the RCT. Development of a formalised framework for RHS, including distinct registration, could contribute to an increased use of valid methods in effectiveness research, thus gaining better and more direct evidence on routine medical practice. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, randomised, health services, evaluation, routine practice
in
International Journal of Cancer
volume
131
issue
12
pages
2898 - 2902
publisher
John Wiley & Sons
external identifiers
  • wos:000310482300018
  • scopus:84867877837
ISSN
0020-7136
DOI
10.1002/ijc.27561
language
English
LU publication?
yes
id
1227a536-8689-4655-b553-f89db97b9e4b (old id 3283292)
date added to LUP
2013-01-07 09:40:03
date last changed
2017-07-23 03:07:53
@article{1227a536-8689-4655-b553-f89db97b9e4b,
  abstract     = {The randomised controlled (or clinical) trial (RCT) is recognized as the most valid among the study designs. The use of RCT in research is widespread and well formalised. In contrast, implementations of new methods and policies in routine health care are commonly lacking a formalised design, impairing the ability to evaluate and improve health care. Use of experimental designs in health care is possible at the implementation phase of clinical or preventive action or more broad process-of-care. We propose the terminology randomised health services studies (RHS) to denote the use of a randomised design with observations in routine health care, regardless of whether randomisation is done at individual, population or process level. In contrast to RCT, the RHS should be based on the same regulative actions, funding mechanisms and ethical framework as routine health care itself. This commentary discusses the different basis, practicalities, and formalities that distinguish the RHS from the RCT. Development of a formalised framework for RHS, including distinct registration, could contribute to an increased use of valid methods in effectiveness research, thus gaining better and more direct evidence on routine medical practice.},
  author       = {Hakama, Matti and Malila, Nea and Dillner, Joakim},
  issn         = {0020-7136},
  keyword      = {epidemiology,randomised,health services,evaluation,routine practice},
  language     = {eng},
  number       = {12},
  pages        = {2898--2902},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Randomised health services studies},
  url          = {http://dx.doi.org/10.1002/ijc.27561},
  volume       = {131},
  year         = {2012},
}