Title of presentation
"RCTs and Prior Evidence: Will the Twain Ever Meet?"
While the importance of basing medical decisions on combining evidence from RCTs is widely recognized, when it comes to the interpretation of individual published RCTs, prior evidence is rarely considered. I will discuss work that documents how bad the situation is with regard to individual RCTs, and present ideas for the incorporation of mechanistic evidence, which EBM removed from the evidential calculus.
Steven Goodman, MD, PhD is a Professor of Oncology, Pediatrics, Biostatistics and Epidemiology in the Johns Hopkins Schools of Medicine and Public Health. He is the senior statistical editor for Annals of Internal Medicine, where he has served for more than two decades, and since 2004 has also been editor of Clinical Trials: Journal of the Society for Clinical Trials.
Goodman directs Project ImpACT, an initiative to find and research the most important RCTs conducted since 1948. He has served on a variety of IOM committees and the Medicare coverage advisory commission, and currently serves as scientific advisor to the Medical Advisory Panel of the Blue Cross-Blue Shield technology assessment program.
At Johns Hopkins he is on the faculties of the Center for Clinical Trials and the Berman Bioethics Institute, where he teaches and writes extensively on scientific and statistical inference, ethics, evidence synthesis and clinical trials. Steve says he has tried to follow Dave Sackett’s advice whenever possible, and has experienced Grade IV career toxicity when he hasn’t.