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April 7, 2010

Evidence From Randomized Controlled Trials, Meta-analyses, and Subgroup Analyses

JAMA. 2010;303(13):1253-1255. doi:10.1001/jama.2010.365

To the Editor: In their Commentary about the need for large-scale RCTs, Drs Hennekens and DeMets1 stated that meta-analyses and subgroup analyses are useful to formulate but not to test hypotheses. They argued that large-scale RCTs are the only available strategy to test a priori hypotheses. This may be understandable using a population perspective. The language of populations is the prevailing idiom of the evidence-based medicine movement, based on the evaluation of interventions, analyses of aggregated data and large sample sizes, predominance of quantitative methods, and results for average patients.

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