Sind Doppelblindstudien immer sinnvoll?

Bücher

2003 veröffentlichte das BMJ einen über die Satire hinausgehenden Artikel von Gordon Smith, in dem er die „Allgläubigkeit“ an randomisierte Studien ironisch thematisierte. In „Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials” (2003; http://www.bmj.com/content/327/7429/1459.full) stellt der Autor fest, dass es keine ausreichende Beweislage für die lebensbewahrende Wirksamkeit von Fallschirmen gibt, letztlich keine einzige randomisierte, kontrollierte Studie:

Results: „We were unable to identify any randomised controlled trials of parachute intervention.”

Conclusions: „As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.”

Beispielhaft einer der Kommentare (von Francisco Felix, Pediatric Hemato-oncologist, Hospital Infantil Albert Sabin – Fortaleza – CE – Brazil; http://www.bmj.com/rapid-response/2011/11/03/evidence-based-madecine):

„However opinions were expressed since its publication, there is little doubt that Smith’s brilliant satire is already a much-cited classic. Comments apart, the guy that called attention for the unwittingness of those who took it very literally and essayed about the science of RCTs and parachuting is cristal clear right: they should read more (in general) and more satiric writings. Smith’s work is an appeal to common sense (not the ‘all doctors are right’ kind of common sense, but the ‘common sense’ kind of common sense). Besides, it is a reflection upon the limits of any methodology when we are in search of truth…”

Quellen

  • Felix, Francisco H: Response to „Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials“. BMJ 2003;327:1459; http://www.bmj.com/rapid-response/2011/11/03/evidence-based-madecine. Zugriff 08.01.2018.
  • Smith, Gordon: Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 327: 1459 doi: 10.1136/bmj.327.7429.1459, Published 18 December 2003. http://www.bmj.com/content/327/7429/1459.full. Zugriff 08.01.2018.