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Do we always need a Randomized Controlled Trial? and a subsequent meta-analysis
Do we always need a Randomized Controlled Trial? Hazardous journeys Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials Gordon C S Smith, Jill P Pell BMJ VOLUME 327 20–27 DECEMBER 2003 Update 2006 next update to be expected?? 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 .
Do we always need a Randomized Controlled Trial? Prospective cohort studies preferable as part of a national audit program can bring strong and valid proof. For example in the Nordic audit report the same reduction of local recurrences after TME and 5x5 Gray are observed as in the Dutch and UK study