WEEK 3 APPRAISING RCT

Introduction to Randomised Controlled Trials (RCTs)

• Definition: RCTs are experimental studies designed to test the efficacy of interventions by randomly allocating participants to different groups.

Learning Outcomes

• Learning Goals:
  • Define sources of bias in experimental research.
  • Discuss how bias affects the trustworthiness of research.
  • Utilize the critical review form to evaluate both mock and published RCTs.

Sources of Bias in RCTs

• Selection Bias: Occurs when the participants selected are not representative of the general population.
• Allocation Bias: Arises when there are systematic differences between groups that are not controlled for during allocation.
• Performance Bias: Differences in care provided apart from the interventions being compared.
• Detection Bias: Variability in how outcomes are assessed, influenced by knowledge of intervention assignment.
• Attrition Bias: Results from participants dropping out of the study, leading to incomplete data.
• Reporting Bias: When researchers selectively report positive results, leading to skewed interpretations.
• Comparator Issues: Problems arise if the comparison group receives treatment that is not appropriate for the study's intent.

Mock RCT Example

• Research Question: Is there a relationship between eating chocolate and hamstring length in adults?
• Methods:
  • Population: Adults.
  • Intervention: Eating chocolate.
  • Comparison: Not eating chocolate.
  • Outcome: Hamstring length measured before and after intervention.

Bias Identification in Mock RCT

• Potential Biases Observed:
  • Selection bias due to non-randomized selection of samples.
  • Allocation bias for not ideally randomizing the groups.
  • Performance bias if care and treatment are not uniform across groups.
  • Reporting bias where only some data points are disclosed.

Evaluating Trustworthiness in RCTs

• Critical Evaluation Questions:
  • How trustworthy are the results, considering the identified biases?
  • What strategies could be implemented to enhance the trustworthiness of the RCT, such as improved randomization methods or blinding?

Teamwork for Assessment 2

• Group Coordination:
  • Assign roles based on skills: Research skills, critical analysis, communication, and organization.
  • Facilitate collaboration through established communication methods.
• Skills to Acknowledge:
  • Empathy, technical proficiency, attention to detail, and creativity.

Assessment Strategies

• Preparation for Future Topics:
  • Complete the critical review for assessment tasks.
  • Engage with additional case studies to enhance practical understanding of evidence-informed practices.
• Trustworthiness Evaluation Table:
  • Utilize provided templates to systematically assess trustworthiness in selected studies and identify points of bias.

Conclusion

• Understanding and addressing bias is crucial for evaluating the trustworthiness of RCTs in health sciences. Following critical review guidelines ensures a rigorous examination of both mock and actual research studies.