Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: In their systematic review,1 Dr King and colleagues conclude that patient preferences
do not affect the validity of randomized controlled trials. However, we believe
that this conclusion should not be generalized to all types of trials.
Very diverse trials were included in their analysis, ranging from highly
technical studies with hard biological outcomes to more qualitative trials
with psychosocial end points. In the latter type of study, patients may feel
more comfortable expressing preferences since they are facing options that
are less technical, and those preferences may be expected to affect subjective
outcomes to a greater extent than objective ones. The authors do note which
studies had subjective or objective outcomes, but this sorting does not take
into account the nature of the interventions themselves.
Cho AH, Jackson GL, Bosworth HB. Patient Preference and Validity of Randomized Controlled Trials. JAMA. 2005;294(1):41-42. doi:10.1001/jama.294.1.41-a