Lecture #15 - RCTs

Question 1

The three essential elements of RCT:
1. Randomised
2. Controlled
3. Trail
Explain 'em

Answer 1

-

Question 2

1. What is a trail? Three steps
2. What do you call the exposure and comparison group?
3. Question answering: “Does the intervention…..”

Answer 2

-

Question 3

Randomisation - what is it related to chance?

Answer 3

-

Question 4

Confounding

So if one group happens to have an older median age, they’ll do worse in the trail. So how does randomising control for that? What does it do with known and unknown confounders?

Answer 4

-

Question 5

How do they tell if randomisation worked?

Answer 5

-

Question 6

What is random selection and how does that differ to randomisation?

Answer 6

-

Question 7

What are two other variants of randomisation?

Answer 7

-

Question 8

What are three main ways of protecting randomisation? (well, main two for them are….)

Answer 8

-

Question 9

Concealment of allocation

1. Important that allocation sequence is ____ and _____
2. Otherwise could……

Answer 9

-

Question 10

Intention-to-treat analysis:

1. Analyse as ______
2. Can more accurately reflect what?
3. Problematic if what?

Per protocol:

1. Analyse as _____
2. Tends to be more appropriate for what?
3. Why do they try to avoid it?

Answer 10

-

Question 11

What are three potential sources of bias?

Answer 11

-

Question 12

Blinding

1. What is it?
2. How does it affect research team members? (3)3. How does it affect participants? (1)
3. How does it affect the clinician?
4. Blinding is important way to prevent against bias but challenging to achieve in practice: (2)

Answer 12

-

Question 13

Loss to follow up:

1. Similar problem as in _____ _____

Answer 13

-

Question 14

Non adherence:

1. What does it mean?
2. Can involve what?
3. How does this affect RCT?

Answer 14

-

Question 15

Advantages of RCT (3):

1. RCT best way to……
2. Can calculate…….so can calculate
3. Strongest design for demonstrating…..
4. What is the hierarchy of evidence?

Answer 15

-

Question 16

Ethical issues with RCT:

1. Need to have ____ ______ (which is genuine…..)
2. Unethical to:
   - Give known _______ intervention to people
   - Give interventions known to be ______ _____ than current treatments
   - Waste resources and risk people’s well being if……

Answer 16

-

Question 17

Practical issues:

1. RCTs are _____ intensive
   - same issues as ____ _____ (time and money difficult to achieve)
   - randomisation more likely to be successful with……but more _____ required
2. Exposures needs to be _____ (explain)
3. Highly ______
   - often a very _____ group of people included
   - can affect ______ (e.g.)

Answer 17

-

Question 18

Cohort vs RCT

What is cohort and what is RCT in a nutshell?

Answer 18

-