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May 23, 2019

The Search for and Conduct of the Elusive Phase 3 Randomized Clinical Trial: Snipe Hunting With the Military

Author Affiliations
  • 1Department of Communicative Disorders, University of Alabama, Tuscaloosa
  • 2Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Otolaryngol Head Neck Surg. 2019;145(7):595-596. doi:10.1001/jamaoto.2019.0830

The hunt for the elusive snipe, an experience shared across generations, dates back to at least the 1840s.1 As most know, a snipe hunt represents the search for, if not the impossible to find, then at least the improbable to observe (ie, the snipe is a real bird). This Viewpoint accompanies the presentation of outcomes for the rare and elusive criterion standard of evidence-based research, the definitive phase 3 randomized clinical trial (RCT). As we describe here, the Tinnitus Retraining Therapy Trial (TRTT)2 metaphorically captures the spirit of improbability of a scientific snipe hunt planned and conducted over a period of 2 decades by civilian academic collaborators and industry partners with military colleagues. With the increasing focus on and commitment by the National Institute on Deafness and Other Communication Disorders (NIDCD) and US Department of Defense to support clinical trials research, this is a timely commentary.

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