Beyond RCTs: Other "Precious Metals"

Randomized controlled trials (RCTs) are the accepted "gold-standard" design for investigating the effects of intervention. However, other experimental designs are typically included in schemes that classify intervention studies (e.g., AAN, 2004). There are several problems with assuming that RCTs should always be considered "gold," and why other designs such as group cohort and single-subject multiple baseline designs—considered "silver" and "bronze—provide substantial evidence of treatment efficacy and effectiveness. RCTs reduce variation in both the population sample and the intervention methodology. Group studies often have exclusion and inclusion criteria that yield a relatively homogeneous sample, and yield only average values for the group. Individuals with TBI are a heterogeneous group, with comorbid conditions that might exclude them from group studies. The results of group studies might not apply to individual clients (Kennedy & Turkstra, 2006; Montgomery & Turkstra, 2003). Thus, silver and bronze designs can greatly contribute to the research evidence and, in particular, provide clinicians with evidence specified to a particular client for a particular kind of intervention.

Text Size:

Print Friendly |

Send to a Friend

In This Issue:

Other Sections