TY - JOUR
T1 - Don't abandon RCTs in IVF. We don't even understand them
AU - Wilkinson, J.
AU - Brison, D. R.
AU - Duffy, J. M. N.
AU - Farquhar, C. M.
AU - Lensen, S.
AU - Mastenbroek, S.
AU - van Wely, M.
AU - Vail, A.
PY - 2019
Y1 - 2019
N2 - The conclusion of the Human Fertilisation and Embryology Authority that 'add-on' therapies in IVF are not supported by high-quality evidence has prompted new questions regarding the role of the randomized controlled trial (RCT) in evaluating infertility treatments. Critics argue that trials are cumbersome tools that provide irrelevant answers. Instead, they argue that greater emphasis should be placed on large observational databases, which can be analysed using powerful algorithms to determine which treatments work and for whom. Although the validity of these arguments rests upon the sciences of statistics and epidemiology, the discussion to date has largely been conducted without reference to these fields. We aim to remedy this omission, by evaluating the arguments against RCTs in IVF from a primarily methodological perspective. We suggest that, while criticism of the status quo is warranted, a retreat from RCTs is more likely to make things worse for patients and clinicians.
AB - The conclusion of the Human Fertilisation and Embryology Authority that 'add-on' therapies in IVF are not supported by high-quality evidence has prompted new questions regarding the role of the randomized controlled trial (RCT) in evaluating infertility treatments. Critics argue that trials are cumbersome tools that provide irrelevant answers. Instead, they argue that greater emphasis should be placed on large observational databases, which can be analysed using powerful algorithms to determine which treatments work and for whom. Although the validity of these arguments rests upon the sciences of statistics and epidemiology, the discussion to date has largely been conducted without reference to these fields. We aim to remedy this omission, by evaluating the arguments against RCTs in IVF from a primarily methodological perspective. We suggest that, while criticism of the status quo is warranted, a retreat from RCTs is more likely to make things worse for patients and clinicians.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85077906738&origin=inward
U2 - https://doi.org/10.1093/humrep/dez199
DO - https://doi.org/10.1093/humrep/dez199
M3 - Review article
SN - 0268-1161
VL - 34
SP - 2093
EP - 2098
JO - Human reproduction (Oxford, England)
JF - Human reproduction (Oxford, England)
IS - 11
ER -