Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”

Abstract Non-pharmaceutical interventions (NPI) for infectious diseases such as COVID-19 are particularly challenging given the complexities of what is both practical and ethical to randomize. We are often faced with the difficult decision between having weak trials or not having a trial at all. In...

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Autores principales:	Noah A. Haber, Sarah E. Wieten, Emily R. Smith, David Nunan
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Non-pharmaceutical interventions Masks Ethics DANMASK-19 Statistical power Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/acc80c986e95464cbc126642a8ed9314
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spelling	oai:doaj.org-article:acc80c986e95464cbc126642a8ed93142021-11-14T12:31:12ZMuch ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”10.1186/s13063-021-05755-y1745-6215https://doaj.org/article/acc80c986e95464cbc126642a8ed93142021-11-01T00:00:00Zhttps://doi.org/10.1186/s13063-021-05755-yhttps://doaj.org/toc/1745-6215Abstract Non-pharmaceutical interventions (NPI) for infectious diseases such as COVID-19 are particularly challenging given the complexities of what is both practical and ethical to randomize. We are often faced with the difficult decision between having weak trials or not having a trial at all. In a recent article, Dr. Atle Fretheim argues that statistically underpowered studies are still valuable, particularly in conjunction with other similar studies in meta-analysis in the context of the DANMASK-19 trial, asking “Surely, some trial evidence must be better than no trial evidence?” However, informative trials are not always feasible, and feasible trials are not always informative. In some cases, even a well-conducted but weakly designed and/or underpowered trial such as DANMASK-19 may be uninformative or worse, both individually and in a body of literature. Meta-analysis, for example, can only resolve issues of statistical power if there is a reasonable expectation of compatible well-designed trials. Uninformative designs may also invite misinformation. Here, we make the case that—when considering informativeness, ethics, and opportunity costs in addition to statistical power—“nothing” is often the better choice.Noah A. HaberSarah E. WietenEmily R. SmithDavid NunanBMCarticleNon-pharmaceutical interventionsMasksEthicsDANMASK-19Statistical powerMedicine (General)R5-920ENTrials, Vol 22, Iss 1, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Non-pharmaceutical interventions Masks Ethics DANMASK-19 Statistical power Medicine (General) R5-920
spellingShingle	Non-pharmaceutical interventions Masks Ethics DANMASK-19 Statistical power Medicine (General) R5-920 Noah A. Haber Sarah E. Wieten Emily R. Smith David Nunan Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”
description	Abstract Non-pharmaceutical interventions (NPI) for infectious diseases such as COVID-19 are particularly challenging given the complexities of what is both practical and ethical to randomize. We are often faced with the difficult decision between having weak trials or not having a trial at all. In a recent article, Dr. Atle Fretheim argues that statistically underpowered studies are still valuable, particularly in conjunction with other similar studies in meta-analysis in the context of the DANMASK-19 trial, asking “Surely, some trial evidence must be better than no trial evidence?” However, informative trials are not always feasible, and feasible trials are not always informative. In some cases, even a well-conducted but weakly designed and/or underpowered trial such as DANMASK-19 may be uninformative or worse, both individually and in a body of literature. Meta-analysis, for example, can only resolve issues of statistical power if there is a reasonable expectation of compatible well-designed trials. Uninformative designs may also invite misinformation. Here, we make the case that—when considering informativeness, ethics, and opportunity costs in addition to statistical power—“nothing” is often the better choice.
format	article
author	Noah A. Haber Sarah E. Wieten Emily R. Smith David Nunan
author_facet	Noah A. Haber Sarah E. Wieten Emily R. Smith David Nunan
author_sort	Noah A. Haber
title	Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”
title_short	Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”
title_full	Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”
title_fullStr	Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”
title_full_unstemmed	Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”
title_sort	much ado about something: a response to “covid-19: underpowered randomised trials, or no randomised trials?”
publisher	BMC
publishDate	2021
url	https://doaj.org/article/acc80c986e95464cbc126642a8ed9314
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Much ado about something: a response to “COVID-19: underpowered randomised trials, or no randomised trials?”

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