In dueling editorials published in the Oct. 4 issue of the British Journal of Anaesthesia, the scientific robustness of randomized controlled trials (RCTs) and evidence-based medicine (EBM) are vigorously debated by pairs of researchers.
In the first editorial, Keane and Berg argue that the vast majority clinical research lacks usefulness, and note that there is an 85 percent waste in the creation and reporting of research evidence.
The researchers suggest that the RCT is fundamentally flawed for complex health care questions, economic theorems are more well-suited to health research issues, and evidence grading lacks utility. Keane and Berg call for an entirely new clinical investigative paradigm.
Moppett and Pearse don’t agree. They argue that EBM – by its very nature – is open to critical analysis and examination, and the problems that exist with EBM can be improved. They implore researchers not to throw the proverbial “baby out with the bathwater,” but to scrutinize and challenge EBM to improve its utility.