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Balancing the Evidence: How to Reconcile the Results of Observational Studies vs. Randomized Clinical Trials in Dialysis
Author(s) -
Shen Jenny I.,
Lum Erik L.,
Chang Tara I.
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12518
Subject(s) - medicine , observational study , randomized controlled trial , intensive care medicine , dialysis
Because large randomized clinical trials ( RCT s) in dialysis have been relatively scarce, evidence‐based dialysis care has depended heavily on the results of observational studies. However, when results from RCT s appear to contradict the findings of observational studies, nephrologists are left to wonder which type of study they should believe. In this editorial, we explore the key differences between observational studies and RCT s in the context of such seemingly conflicting studies in dialysis. Confounding is the major limitation of observational studies, whereas low statistical power and problems with external validity are more likely to limit the findings of RCT s. Differences in the specification of the population, exposure, and outcomes can also contribute to different results among RCT s and observational studies. Rigorous methods are required regardless of what type of study is conducted, and readers should not automatically assume that one type of study design is superior to the other. Ultimately, dialysis care requires both well‐designed, well‐conducted observational studies and RCT s to move the field forward.