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This design is approved by Cochrane for use in systematic reviews of interventions " that cannot be randomized, or which are extremely unlikely to be studied in randomized trials" [ 28].
As for the majority of studies that involve interventions that cannot be blinded, the current study design has a potential risk of non-compliance of participants with the intervention they are randomised to.
More and more, policymakers are being pushed to base their decisions on evidence that is regularly evolving and, occasionally, changing, especially for complex interventions that cannot be tested everywhere prior to adoption.
Advantages of cluster RCTs over individually randomised controlled trials include the ability to study interventions that cannot be directed toward selected individuals and the ability to control for "contamination" across individuals, that is, the unintentional spillover of intervention effects from one treatment group to another.
For example, in obesity studies, genetically modified models (such as the ob/ob leptin-deficient mouse) and germ-free mouse models are indispensable because they allow interventions that cannot be performed in humans to provide evidence of how gut bacteria influences host metabolism (Bäckhed et al., 2007).
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A miracle is an intervention that cannot be accounted for purely rationally.
Specifically, it may be possible to use a quasi-experiment to study the causal effect of an intervention that cannot feasibly be randomized or that would be unethical (e.g., because the intervention has become the standard of care) to test in a randomized controlled trial (RCT).
I do consider it my duty, to myself and younger generations, to follow the example my mother set by doing everything in my power to ensure that I will never be the object of medical intervention that cannot restore my life but can only prolong a costly living death.
As a case in point, these novel platform will enhance our capacity to identify, using in vivo RNAi screens, points of intervention that cannot be discovered in cell-based assays, such as modulators of the tumour microenvironment, tumour immunity, and bystander killing.
A group of international experts have recently collaborated to produce an exhaustive taxonomy of BCTs, which names active behaviour change intervention techniques that cannot be reduced to smaller components, such as goal setting or self-monitoring of behaviour.
Cost-outcomes analysis provides a more comprehensive presentation of information than other types of economic evaluation and is appropriate for complex interventions that generate outcomes that cannot meaningfully be expressed using a single metric such as those in this study.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com