Title |
Circular instead of hierarchical: methodological principles for the evaluation of complex interventions
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Published in |
BMC Medical Research Methodology, June 2006
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DOI | 10.1186/1471-2288-6-29 |
Pubmed ID | |
Authors |
Harald Walach, Torkel Falkenberg, Vinjar Fønnebø, George Lewith, Wayne B Jonas |
Abstract |
The reasoning behind evaluating medical interventions is that a hierarchy of methods exists which successively produce improved and therefore more rigorous evidence based medicine upon which to make clinical decisions. At the foundation of this hierarchy are case studies, retrospective and prospective case series, followed by cohort studies with historical and concomitant non-randomized controls. Open-label randomized controlled studies (RCTs), and finally blinded, placebo-controlled RCTs, which offer most internal validity are considered the most reliable evidence. Rigorous RCTs remove bias. Evidence from RCTs forms the basis of meta-analyses and systematic reviews. This hierarchy, founded on a pharmacological model of therapy, is generalized to other interventions which may be complex and non-pharmacological (healing, acupuncture and surgery). |
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Spain | 4 | 36% |
Canada | 1 | 9% |
Australia | 1 | 9% |
Sweden | 1 | 9% |
United Kingdom | 1 | 9% |
Unknown | 3 | 27% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 9 | 82% |
Scientists | 1 | 9% |
Practitioners (doctors, other healthcare professionals) | 1 | 9% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
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United States | 3 | 1% |
Germany | 1 | <1% |
Australia | 1 | <1% |
Netherlands | 1 | <1% |
Portugal | 1 | <1% |
New Zealand | 1 | <1% |
Canada | 1 | <1% |
Japan | 1 | <1% |
Other | 1 | <1% |
Unknown | 199 | 91% |
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Researcher | 47 | 21% |
Student > Master | 30 | 14% |
Student > Ph. D. Student | 25 | 11% |
Student > Bachelor | 23 | 11% |
Student > Doctoral Student | 14 | 6% |
Other | 52 | 24% |
Unknown | 28 | 13% |
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Social Sciences | 15 | 7% |
Psychology | 9 | 4% |
Agricultural and Biological Sciences | 9 | 4% |
Other | 27 | 12% |
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