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On the basis of randomised clinical trials, sorafenib has been approved for the treatment of renal cell carcinoma and hepatocellular carcinoma (Escudier et al, 2007; Llovet et al, 2008a).
Whether or not this translates into clinical effectiveness and whether or not Ukrain does indeed cure some type of cancer or improves their prognosis can best be decided on the basis of randomised clinical trials (RCTs).
According to these meta-analyses performed on the basis of randomised placebo-controlled trials, rituximab, abatacept and anakinra seem to be safe as regards the risk of serious infections.
Our study showed that most ophthalmic drugs over the past decade were approved on the basis of randomised, controlled and masked pivotal trials, and subgroup information was not frequently available for approved ophthalmic therapeutics.
On the basis of randomised trials, the overdiagnosis is 30% (Gøtzsche and Nielsen, 2006), and it becomes 44% if adjusted for opportunistic screening in the control groups (Jørgensen and Gøtzsche, 2008).
Uniform extension of invitations to women aged 60 69 years, as recommended on the basis of randomised trials, will increase the number of deaths prevented at 60 79 years of age.
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There are a number of possible reasons why the effect of screening on mortality in the current trial may be less than that expected on the basis of other randomised trials.
Many western European countries implemented mammography screening on the basis of several randomised trials initiated in the 1970s that showed a statistically significant reduction in mortality rates in screened women aged 50 and older [ 3, 4].
On the basis of large randomised clinical trials, irinotecan either alone or in combination with fluorouracil has been accepted as first- or second-line chemotherapy for the treatment of patients with colorectal cancer (Cunningham et al, 1998; Rougier et al, 1998; Douillard et al, 2000; Saltz et al, 2000).
Screening for abdominal aortic aneurysm in men over 65 years of age has been recommended on the basis of several randomised controlled trials and meta-analyses. 1 2 These studies have shown that a single screening examination using ultrasound with follow-up intervention as appropriate can reduce aneurysm related mortality, with benefits extending to at least 10 years.
However, as not all trials are freely available and some health professionals do not have access to the full trial reports, healthcare decisions are sometimes made on the basis of abstracts of randomised trials.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com