Powell: Randomized Clinical Trials are not the whole story

Written by on October 7, 2011 in clinical trials with 0 Comments

Writing in the British Journal of Dermatology, the well known Rosacea Researcher Professor Frank Powell says that research based on randomized clinical trials are not the be-all and end-all for rosacea research. He tells us that there is still room for other sorts of innovation, especially when seeking treatments from your dermatologist.

Recently a Cochrane review of 58 clinical trials told us that Metrogel, Finacea and Oracea are Best for Rosacea.

What is a Cochrane Review?

From The Cochrane Collaboration: Cochrane Reviews are designed to facilitate the choices that doctors, patients, policy makers and others face in health care. Most Cochrane Reviews are based on randomized controlled trials, but other types of evidence may also be taken into account, if appropriate.

Powell’s Comments

Interventions for ‘rosacea’

F.C. Powell, S. Ni Raghallaigh, British Journal of Dermatology, Volume 165, Issue 4, pages 707–708, October 2011

[speaking of Cochran Reviews] Reviews such as these are important summaries of evidence relating to the efficacy of particular treatments. They also reinforce the need for high-quality RCTs for future research. However, dermatologists should be aware that this review has limitations for clinical practice for two main reasons.

[read more]

Professor Powell suggests 3 reasons that large clinical trials are only part of the story. Here is my paraphrasing.

  • Firstly, clinical trials almost always only interested in treating the papules and pustules of rosacea.
  • Secondly, it is also worth noting that because large clinical trials are so expensive, only big pharmaceuticals companies will fund them. This leads to a bias where cheap traditional treatments are unlikely to be explored. It makes perfect sense that pharmaceutical companies want to research and develop new products that will lead to profits for their shareholders.
  • Thirdly only concentrating on large trials will inhibit experimentation by dermatologists that drive the innovation we see in the “short form report” journal article.

As much I really want to see new treatments proven effective by a randomized trial, I do appreciate that this approach really is too restrictive. None of us want to visit the doctor and only have them offer the same old treatments, especially if they have already been found wanting.

Dermatologists that are willing to try innovative methods based on their knowledge – that really is something we need to encourage.

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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