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Nevertheless, in situations in which a randomized trial is impractical or would take a long time to complete, valuable information can be gathered from an observational study, provided that the study is designed and analyzed appropriately.
The MRC emphasise the need for robust and rigorous evaluation of complex interventions, promoting the use of experimental methods, but providing information on some of the alternatives to the conventional randomised controlled trial and highlighting situations in which a trial is impractical or undesirable [ 4].
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They are good for generating hypotheses or perhaps when clinical trials are impractical.
The difficulty with this assumption is that there are situations where randomized control trials are impractical or unethical [ 31, 74].
Case study approaches are also considered suitable for exploratory research of inadequately understood phenomena, and where randomized control trials are impractical or unethical [ 44].
Clinical trial design is impractical for assessing the effectiveness of some interventions, such as face masks and isolation, because of ethical considerations relating to epidemics in general.
18 19 In most rehabilitation trials it is impractical and unacceptable to blind participants and those delivering the intervention to the allocation group.
However, running a randomized controlled trial of hospital mergers is impractical.
More generally, we advocate for a stronger evidence base for infection prevention and control of norovirus in healthcare settings, well designed controlled trials, or, where that is impractical or unethical, observational studies should be conducted on interventions, including ward closure, disinfection regimes, and cohorting strategies.
A trial would be impractical while war was still raging; a trial would disrupt the peace process; a trial would upset a hard-won equilibrium and reopen old wounds.
Often, the ultimate aim of treatment is to increase survival, but it is impractical for trials involving younger patients to have survival as a primary end-point.
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