Mol A, Karayalcin C
Universiteit Twente, Faculteit Gedragswetenschappen, Enschede, The Netherlands.
Tijdschr Psychiatr. 2008;50(6):359-64.
Randomised clinical trials (RCTs) generate knowledge that is useful in some situations but is of limited value when it comes to dealing with complex problems in clinical practice. By means of arguments drawn from acute psychiatry it is argued in this paper that a) the preconditions under which an intervention seems to work in a trial are all too often not met in the clinic; b) the problems that evidence-based interventions seek to solve tend to be unlike the problems that clinicians encounter in a day-to-day basis; and c) it is often impossible to ascertain the parameters against which the efficacy of intervention can be measured. Therefore, acute psychiatry, like all the other branches of healthcare, urgently needs not only information about 'proven efficacy' via RCTs but also other kinds of information derived from other methods of research.
随机对照试验（RCTs）所产生的知识在某些情况下是有用的，但在处理临床实践中的复杂问题时价值有限。本文通过引用急性精神病学的观点进行论证，即：a）干预措施在试验中看似有效的前提条件在临床中常常无法满足；b）循证干预措施试图解决的问题往往与临床医生日常遇到的问题不同；c）通常无法确定用以衡量干预效果的参数。因此，与医疗保健的所有其他分支一样，急性精神病学迫切需要的不仅是通过随机对照试验获得的关于“已证实疗效”的信息，还需要从其他研究方法中获得的其他类型的信息。
