2019 Nobel Prize in Economic Sciences is about limitations of RCT

[R_cubed]

I posted a host of references on this very topic here.

Stability of results from small RCTs

Blockquote Randomization does not guarantee exchangeability. The very definition of random implies imbalances in prognostic factors could happen, even if they are more and more rare as the sample size increases. This very important point is carefully elaborated in the following: So that leads me to the following question: Are small randomized trials worth conducting? In a previous post @f2harrell wrote: Blockquote Most statisticians I’ve spoken with who frequently collaborate with …

I got interested in this issue because, in my field of rehabilitation, we are almost certainly never going to be in a position to do a reasonably credible RCT. You can find more information about this by searching for “minimized clinical trial.”

This is a challenging philosophical issue, but it might be a bit more accurate to say RCTs might be “overvalued” in certain contexts, relative to the information they provide.

For drugs and devices, they have the best justification. For certain “softer” interventions, I think other methods should be explored.

Randomized, Controlled Trials, Observational Studies, and the Hierarchy of Research Designs (link)

I’m looking forward to input from people who have actual experience in this area. AFAICT, minimized designs account for a tiny fraction (less than 3%) of all controlled trials. In areas where sample sizes are condemned to be “small” (ie. less than 200 per arm) I think minimization is worth consideration.