Assessing the usefulness of randomised trials in obstetrics and gynaecology

Janneke van 't Hooft* (Corresponding Author), Charlotte E van Dijk, Cathrine Axfors, Zarko Alfirevic, Martijn A Oudijk, Khalid S Khan, Ben W J Mol, Patrick M Bossuyt, John P A Ioannidis

*Corresponding author for this work

Research output: Contribution to journalComment/debate


Healthcare professionals will be familiar with how little of what they read in medical journals is of direct value (useful) to their practice. Randomised controlled trials (RCTs) are traditionally placed at the top of the hierarchy of evidence validity for healthcare interventions. However, even the majority of RCTs do not seem useful in that they may not lead to any tangible improvements in clinical decision making. Increasing the usefulness of RCTs can benefit society, providing better solutions for patient problems and reducing waste in medical research budgets. In this commentary we discuss the usefulness of RCTs for healthcare interventions and propose a tool for structured assessment. We describe some examples of where RCTs have demonstrated usefulness in the field of women's health and some where they may have been less useful.
Original languageEnglish
JournalBJOG : an international journal of obstetrics and gynaecology
Early online date19 Feb 2023
Publication statusE-pub ahead of print - 19 Feb 2023


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