“Compared to What” was a song composed and recorded in the 1960s by several jazz artists, with 1 rendition by McCann and Harris often mentioned as one of the best jazz live performances ever. The song addressed societal problems of the times, with lyrics “Nobody gives us rhyme or reason/Have one doubt, they call it treason.” So, is it reasonable or treason to consider alternative approaches to a definitive randomized clinical trial in bariatric surgery? Can large data sets, such as the one used in the article by Howard et al1 in this issue of JAMA Surgery, contribute to filling knowledge gaps where larger randomized clinical trials do not exist? The answer is likely yes, but only if the novel methods are understood and accepted.
Courcoulas AP, Ahmed B. Compared to What?—Novel Methods to Approach Randomization for Long-term Bariatric Surgery Outcomes. JAMA Surg. 2021;156(12):1169–1170. doi:10.1001/jamasurg.2021.4989
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