What is the "Gold Standard" for knowledge about the effects of care? Why are "randomized controlled trials" and "systematic reviews" valuable resources?

Among individual studies, a randomized controlled trial (or RCT) can provide especially strong research evidence. In this type of research, participants are randomized — assigned by chance — to receive one or another form of care. Those receiving usual care (or placebo treatment such as a sugar pill) are in the control group. Those receiving the type of care that is being studied are in the treatment or experimental group. Random assignment helps ensure that the groups are truly similar, and that any differences in outcomes are due to the treatment under study.

A rigorous systematic review of studies, conducted according established guidelines for research, gives the best possible answers to questions about the safety and effectiveness of specific health interventions. A systematic review involves a thorough search for the best available studies on a specific topic. If available, randomized controlled trial research is generally preferred. Only relevant and better quality studies are included in the review. When possible, researchers reach a conclusion by combining data from the included studies with statistical techniques called meta-analysis. Systematic review procedures help limit the bias and error that can easily influence results of single studies and of more conventional reviews of research. They allow us to draw much more accurate and confident conclusions.

Fortunately, we now have many thousands of reports of randomized controlled trials and many systematic reviews about the safety and effectiveness of specific maternity care practices to help guide care decisions.

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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 2/13/2006