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Books, Journals, New Media
February 25, 1998


Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(8):584. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-8-jbk0225

In Reply.—We agree that the comparison of medical vs surgical treatments is complex. However, Dr Bonchek's overall conclusion that "it is often impossible to make enough statistical adjustments in studies that compare surgical with nonsurgical therapy" seems to be suggesting that randomized clinical trials (RCTs) may be inappropriate to establish the relative efficacy in challenging clinical situations. We suggest that while RCTs of medical vs surgical trials present challenges, the objective comparison of treatments by RCTs remains central to the scientific advancement of medicine.

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