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Pragmatic randomised controlled trials in psychiatry

Published online by Cambridge University Press:  03 January 2018

Matthew Hotopf ,
Rachel Churchill  and
Glyn Lewis
Matthew Hotopf*
Affiliation:
Guys, Kings and St Thomas' Schools of Medicine, and Institute of Psychiatry, London
Rachel Churchill
Affiliation:
Institute of Psychiatry, London
Glyn Lewis
Affiliation:
University of Wales College of Medicine, Heath Park, Cardiff
*
Dr Matthew Hotopf, Department of Psychological Medicine, Guy's, King's and St Thomas' Schools of Medicine, and Institute of Psychiatry, 103 Denmark Hill, London SE5 8AZ. Tel: 0171 740 5073; Fax: 0171 740 5129; e-mail: [email protected]
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Abstract

Background

Randomised controlled trials (RCTs) are the most important method of evaluating new treatments and treatment policies. Despite this, there are relatively few large pragmatic RCTs in psychiatry.

Aims

To explore the main advantages of large pragmatic RCTs and the obstacles to performing them in psychiatry.

Method

A narrative review of literature on pragmatic RCTs with examples drawn from psychiatry and other medical specialities.

Results

Obstacles to performing pragmatic RCTs in psychiatry include the complexity of psychiatric interventions, the complexity of outcomes used in psychiatry and the difficulties of blinding subjects and investigators to some psychiatric interventions.

Conclusions

Researchers need to frame questions in a form that is relevant to clinicians and to convince clinicians to cooperate in simple large pragmatic trials.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 175 , Issue 3 , September 1999 , pp. 217 - 223
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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