Peer Review and the Randomized Controlled Trial: Helping Sports Medicine Realize the Level I Hype - Reviewer Workshop from July 2022 AOSSM Annual Meeting-Peer Review and the Randomized Controlled Trial: Helping Sports Medicine Realize the Level I Hype

Peer Review and the Randomized Controlled Trial: Helping Sports Medicine Realize the Level I Hype

Video Transcription

Video Summary

The video begins by discussing the importance of evidence-based medicine and the role of randomized control trials (RCTs) in improving clinical care. However, it is emphasized that not all RCTs are equal and they must be critically evaluated to ensure accurate results. The speaker then delves into specific issues related to the review of RCTs, including balancing table one and the use of inappropriate p-values, assessing outcomes and hypothesis testing, trial registration, between-group comparisons, and the potential for spin. The importance of machine learning algorithms in analyzing RCT data is also discussed, but caution is advised regarding sample size, treatment heterogeneity, and the need to prioritize between-group comparisons. The speaker emphasizes the need for proper assessment of group balancing after randomization and stresses that p-values should not be used to determine group balance. Additionally, the importance of respecting the primary outcome and protecting alpha is highlighted. The speaker suggests that using machine learning algorithms with RCT data should be approached with caution and considerations of sample size and treatment heterogeneity. The need for trial registration and addressing potential biases is also discussed. The speaker concludes by acknowledging that while imperfect, RCT data should still be used to make the most of available evidence.

Asset Caption

David C. Landy, MD, PhD

Keywords

evidence-based medicine

randomized control trials

RCTs

clinical care

trial evaluation

machine learning algorithms

group balancing