Randomized Trials Versus the Real World

Randomized Trials Versus the Real World - CME Teaching Brief - MedPage Today:
"this study, the mean number of chronic conditions of patients in a primary care practice eligible for randomized clinical trials in the area of hypertension ranged from 5.5 - 3.3 to 11.7 - 5.3.
Explain to interested patients that the randomized controlled trials for a common condition they read about, hypertension for instance, tend to exclude or omit data on patients with co-morbid conditions. Such exclusions may make it difficult for primary care practitioners, who care for many patients with multiple conditions, to determine for whom the guidelines are relevant.
Review
SHERBROOKE, Quebec, March 28 - Randomized controlled trials are used to support clinical practice guidelines, but their results may have limited relevance to physicians in the trenches.
That's the issue studied by investigators here, who evaluated whether randomized controlled trials that may have excluded patients with co-morbidities provide useful information for clinical practice. They described their research in the March/April issue of the Annals of Family Medicine.
'With our study, we wanted to call attention to an issue of increasing relevance -- comorbidity,' wrote Martin Fortin, M.D., M.Sc., of the department of family medicine at Sherbrooke University, and colleagues.
'Results from our study suggest that randomized controlled trials targeting a chronic medical condition such as hypertension would most likely find a great many patients with co-morbid conditions during the screening process,' they wrote./.../ "