What trials are really supposed to be – a succinct reminder from J. Ioannidis

In his recent editorial for the BMJ John Ioannidis writes:

“Trials should be properly randomized (currently more than half are not randomized at all) and use optimal study designs. They should ask key questions that matter to patients and the public, and they should be informed by a systematic examination of previous evidence. Trials should be well powered and use the best comparators, with pre-registration of their design and outcomes, and, whenever possible, of the analysis plan. They should avoid overt conflicts in their funding. They should be designed and conducted by non-conflicted trialists. Their results and their raw data should be publicly available and transparent. Eventually, randomized controlled trials could be the pride of clinical investigators who collaborate in research that matters, and the best source of information on how to improve health. This is what trials were supposed to be, even if we have almost totally forgotten this over the years.”

JPA Ioannidis. Clinical trials: what a waste. BMJ 2014;349:g7089. doi: http://dx.doi.org/10.1136/bmj.g7089 (Published 10 December 2014)