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Fernainy P, Cohen AA, Murray E, Losina E, Lamontagne F, Sourial N. Rethinking the pros and cons of randomized controlled trials and observational studies in the era of big data and advanced methods: a panel discussion. BMC Proc 2024; 18:1. [PMID: 38233894 PMCID: PMC10795211 DOI: 10.1186/s12919-023-00285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
Randomized controlled trials (RCTs) have traditionally been considered the gold standard for medical evidence. However, in light of emerging methodologies in data science, many experts question the role of RCTs. Within this context, experts in the USA and Canada came together to debate whether the primacy of RCTs as the gold standard for medical evidence, still holds in light of recent methodological advances in data science and in the era of big data. The purpose of this manuscript, aims to raise awareness of the pros and cons of RCTs and observational studies in order to help guide clinicians, researchers, students, and decision-makers in making informed decisions on the quality of medical evidence to support their work. In particular, new and underappreciated advantages and disadvantages of both designs are contrasted. Innovations taking place in both of these research methodologies, which can blur the lines between the two, are also discussed. Finally, practical guidance for clinicians and future directions in assessing the quality of evidence is offered.
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Affiliation(s)
- Pamela Fernainy
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada.
- Research Centre of the Centre Hospitalier de L'Université de Montréal (CHUM), Montreal, QC, Canada.
| | - Alan A Cohen
- Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Montreal, QC, Canada
- CHUS Research Centre, Montreal, QC, Canada
- Centre de Recherche Sur Le Vieillissement, Montreal, QC, Canada
- Butler Columbia Aging Center, New York, NY, USA
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University New York, New York, USA
| | - Eleanor Murray
- School of Public Health, Boston University, Boston, MA, USA
| | - Elena Losina
- Harvard Medical School Department of Orthopedic Surgery, Cambridge, MA, USA
| | - Francois Lamontagne
- CHUS Research Centre, Montreal, QC, Canada
- Departement de Medicine, University of Sherbrooke, Montreal, QC, Canada
| | - Nadia Sourial
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada
- Research Centre of the Centre Hospitalier de L'Université de Montréal (CHUM), Montreal, QC, Canada
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