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Randomization is the heart of the RCT

Design/steps (Concurrent or parallel study)

  1. Establish a comprehensive protocol outlining aims, objectives, and the questionnaire. 

    • Conduct preliminary or pilot studies to validate the protocol.

  2. Choose a suitable/reference/target population.

  3. Select the experiment/study population. 

    • Randomly select individuals from the reference population and match them as closely as possible. 

    • Obtain informed consent from eligible participants.

  4. Choose a control population based on the protocol.

  5. Randomize the eligible population (experimental and control population). 

    • Utilize a statistical procedure to allocate participants randomly into study and control groups.

    • Randomization aids in eliminating selection bias and ensures comparability.

  6. Implement manipulation of the experimental population (e.g., vaccination).

  7. Follow up with both the experimental and control populations.

  8. Assess the outcome.

Potential Bias in Randomized Controlled Trials (RCT) that cannot be entirely eliminated through randomization. Blinding is implemented to mitigate these biases.

  • Variability among subjects
  • Observer bias
  • Assessment bias

Randomized Controlled Trials | Medical Science Optional Notes for UPSC

Question for Randomized Controlled Trials
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What is an advantage of crossover study designs?
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Crossover Study Design

  • Each patient functions as their own control, eliminating the need for a separate control group.
  • At the trial's onset, the study group receives the intervention, while the control group receives a placebo.
  • After a certain period, interventions, including the placebo, are withdrawn from both the study and control groups (SWITCH OFF).
  • The two groups are then switched, with the control group transitioning to the study group, and vice versa.

Advantages of crossover studies:

  • All patients are ensured intervention at some point in the trial.
  • Economical benefits (cost-saving).

Disadvantages:

  • Time-consuming due to the SWITCH OFF period.
  • If the studied disease is cured by the intervention, making a SWITCH OFF infeasible, a crossover study cannot be conducted.

Types of RCT

  • Trials in clinical settings.
  • Trials focusing on preventive measures.
  • Trials assessing risk factors.
  • Experiments related to cessation.
  • Trials investigating etiological agents.
  • Assessment of health services.

Question for Randomized Controlled Trials
Try yourself:
What is the purpose of randomization in a randomized controlled trial (RCT)?
View Solution




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FAQs on Randomized Controlled Trials - Medical Science Optional Notes for UPSC

1. What is a randomized controlled trial (RCT)?
Ans. A randomized controlled trial (RCT) is a type of study design used in research to evaluate the effectiveness of a particular intervention or treatment. In an RCT, participants are randomly assigned to either an experimental group that receives the intervention or a control group that does not receive the intervention. This randomization helps to minimize bias and ensure that any observed differences between the groups can be attributed to the intervention being tested.
2. What is the difference between concurrent and parallel study designs in RCTs?
Ans. In a concurrent study design, participants in both the experimental and control groups are enrolled and followed simultaneously. This means that the intervention and control groups receive the treatment or intervention at the same time. On the other hand, in a parallel study design, participants are enrolled and followed separately, with one group receiving the intervention and the other group serving as the control. The key difference between the two designs is the timing of when the intervention is administered to the participants.
3. Why is randomization important in RCTs?
Ans. Randomization is important in RCTs because it helps to ensure that the two groups being compared are similar in terms of their characteristics and potential confounding factors. By randomly assigning participants to the intervention and control groups, researchers can minimize the impact of bias and other factors that may influence the outcomes of the study. This increases the reliability and validity of the study results, allowing for a more accurate assessment of the intervention's effectiveness.
4. How are RCTs useful in UPSC exams?
Ans. RCTs are useful in UPSC exams as they provide a scientific and evidence-based approach to evaluating the effectiveness of interventions or policies. By understanding the design and principles of RCTs, UPSC aspirants can critically analyze research studies and assess the credibility and validity of their findings. This knowledge can help in answering questions related to public health, policy-making, and evidence-based decision-making during the UPSC exams.
5. What are some limitations of RCTs in research?
Ans. While RCTs are considered the gold standard in research, they do have some limitations. One limitation is the ethical concerns associated with randomly assigning participants to different groups, especially if the intervention being tested may have potential harm or benefits. Additionally, RCTs may not always be feasible or practical due to logistical or financial constraints. There may also be challenges in generalizing the findings of RCTs to real-world settings, as the study conditions may differ from the actual implementation conditions. It is important to consider these limitations when interpreting the results of RCTs in research.
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