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July 6, 2005

Patient Preference and Validity of Randomized Controlled Trials

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294(1):41-42. doi:10.1001/jama.294.1.41-a

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.

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