- Section 1 Patients and their treatment
- Section 2 Background to medicine
- 2.1 Science in medicine: When, how, and what
- 2.2 Evolution: Medicine’s most basic science
- 2.3 The Global Burden of Disease: Measuring the health of populations
- 2.4 Large-scale randomized evidence: Trials and meta-analyses of trials
- 2.5 Bioinformatics
- 2.6 Principles of clinical pharmacology and drug therapy
- 2.7 Biological therapies for immune, inflammatory, and allergic diseases
- 2.8 Traditional medicine exemplified by traditional Chinese medicine
- 2.9 Engaging patients in therapeutic development
- 2.10 Medicine quality, physicians, and patients
- 2.11 Preventive medicine
- 2.12 Medical screening
- 2.13 Health promotion
- 2.14 Deprivation and health
- 2.15 How much should rich countries’ governments spend on healthcare?
- 2.16 Financing healthcare in low-income developing countries: A challenge for equity in health
- 2.17 Research in the developed world <i>(a view from the Wellcome Trust</i>)
- 2.18 Fostering medical and health research in resource-constrained countries
- 2.19 Regulation versus innovation in medicine
- 2.20 Human disasters
- 2.21 Humanitarian medicine
- 2.22 Complementary and alternative medicine
- Section 3 Cell biology
- Section 4 Immunological mechanisms
- Section 5 Principles of clinical oncology
- Section 6 Old age medicine
- Section 7 Pain and palliative care
- Section 8 Infectious diseases
- Section 9 Sexually transmitted diseases
- Section 10 Environmental medicine, occupational medicine, and poisoning
- Section 11 Nutrition
- Section 12 Metabolic disorders
- Section 13 Endocrine disorders
- Section 14 Medical disorders in pregnancy
- Section 15 Gastroenterological disorders
- Section 16 Cardiovascular disorders
- Section 17 Critical care medicine
- Section 18 Respiratory disorders
- Section 19 Rheumatological disorders
- Section 20 Disorders of the skeleton
- Section 21 Disorders of the kidney and urinary tract
- Section 22 Haematological disorders
- Section 23 Disorders of the skin
- Section 24 Neurological disorders
- Section 25 Disorders of the eye
- Section 26 Psychiatric and drug-related disorders
- Section 27 Forensic medicine
- Section 28 Sport and exercise medicine
- Section 29 Biochemistry in medicine
- Section 30 Acute medicine
(p. 51) Large-scale randomized evidence: Trials and meta-analyses of trials
- Chapter:
- (p. 51) Large-scale randomized evidence: Trials and meta-analyses of trials
- Author(s):
Colin Baigent
, Richard Peto
, Richard Gray
, Natalie Staplin
, Sarah Parish
, and Rory Collins
- DOI:
- 10.1093/med/9780198746690.003.0010
Clinical trials generally need to be able to detect or to refute realistically moderate (but still worthwhile) differences between treatments in long-term disease outcome. Large-scale randomized evidence should be able to detect such effects, but medium-sized trials or medium-sized meta-analyses can, and often do, yield false-negative or exaggeratedly positive results. Hundreds of thousands of premature deaths each year could be avoided by seeking appropriately large-scale randomized evidence about various widely practicable treatments for the common causes of death, and by disseminating this evidence appropriately. This chapter takes a look at the use of large-scale randomized evidence—produced from trials and meta-analysis of trials—and how this data should be handled in order to produce accurate result.
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- Section 1 Patients and their treatment
- Section 2 Background to medicine
- 2.1 Science in medicine: When, how, and what
- 2.2 Evolution: Medicine’s most basic science
- 2.3 The Global Burden of Disease: Measuring the health of populations
- 2.4 Large-scale randomized evidence: Trials and meta-analyses of trials
- 2.5 Bioinformatics
- 2.6 Principles of clinical pharmacology and drug therapy
- 2.7 Biological therapies for immune, inflammatory, and allergic diseases
- 2.8 Traditional medicine exemplified by traditional Chinese medicine
- 2.9 Engaging patients in therapeutic development
- 2.10 Medicine quality, physicians, and patients
- 2.11 Preventive medicine
- 2.12 Medical screening
- 2.13 Health promotion
- 2.14 Deprivation and health
- 2.15 How much should rich countries’ governments spend on healthcare?
- 2.16 Financing healthcare in low-income developing countries: A challenge for equity in health
- 2.17 Research in the developed world <i>(a view from the Wellcome Trust</i>)
- 2.18 Fostering medical and health research in resource-constrained countries
- 2.19 Regulation versus innovation in medicine
- 2.20 Human disasters
- 2.21 Humanitarian medicine
- 2.22 Complementary and alternative medicine
- Section 3 Cell biology
- Section 4 Immunological mechanisms
- Section 5 Principles of clinical oncology
- Section 6 Old age medicine
- Section 7 Pain and palliative care
- Section 8 Infectious diseases
- Section 9 Sexually transmitted diseases
- Section 10 Environmental medicine, occupational medicine, and poisoning
- Section 11 Nutrition
- Section 12 Metabolic disorders
- Section 13 Endocrine disorders
- Section 14 Medical disorders in pregnancy
- Section 15 Gastroenterological disorders
- Section 16 Cardiovascular disorders
- Section 17 Critical care medicine
- Section 18 Respiratory disorders
- Section 19 Rheumatological disorders
- Section 20 Disorders of the skeleton
- Section 21 Disorders of the kidney and urinary tract
- Section 22 Haematological disorders
- Section 23 Disorders of the skin
- Section 24 Neurological disorders
- Section 25 Disorders of the eye
- Section 26 Psychiatric and drug-related disorders
- Section 27 Forensic medicine
- Section 28 Sport and exercise medicine
- Section 29 Biochemistry in medicine
- Section 30 Acute medicine