Advances in chronic kidney disease
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Adv Chronic Kidney Dis · Jan 2012
ReviewRandomized controlled trials in nephrology: state of the evidence and critiquing the evidence.
The randomized controlled trial (RCT) remains the "gold standard" for the evaluation of therapies. Despite some progress during the past decade, the number and quality of published RCTs addressing the core issues for patients with CKD and with renal diseases, in general, lag behind other areas in internal medicine. The paucity of robust evidence results in fewer patients receiving evidence-based therapies in nephrology and fewer rigorous systematic reviews to inform nephrology practice and health care policy. ⋯ A detailed discussion of the most important design elements for the conduct of a high-quality RCT is described in the text. These considerations are placed into the context of critical appraisal tools. These tools allow the clinician to efficiently assess the quality of published RCTs and to determine how the new RCT evidence should change current best practice.