What is equipoise in rct

Results  Seven trials including 1214 newborns were identified. Therapeutic hypothermia resulted in a reduction in the risk of death or major neurodevelopmental disability (risk ratio [RR], ; 95% CI, -) and increase in the rate of survival with normal neurological function (; -) at age 18 months. Hypothermia reduced the risk of death or major neurodevelopmental disability at age 18 months in newborns with moderate HIE (RR, ; 95% CI, -) and in newborns with severe HIE (; -). Both total body cooling and selective head cooling resulted in reduction in the risk of death or major neurodevelopmental disability (RR, ; 95% CI, - and ; -, respectively).

Active release technique (ART) is a patented soft tissue system that treats problems with muscles, tendons, ligaments, fascia and nerves (., headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow).  These conditions have one important commonality -- they often result from injury to over-used muscles.  Each ART session is a combination of examination and treatment.  The ART provider uses his/her hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves.  Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.  These treatment protocols -- over 500 specific moves -- are unique to ART.  They supposedly allow providers to identify and correct the specific problems that are affecting each individual patient.  Active release technique is similar to some massage techniques, albeit more aggressive.

I can’t help but compare this protocol to the VSE (vasopressin+steroids+epinephrine) protocol in cardiac arrest. The VSE  protocol was subjected to a randomized controlled trial in 2009 and again in 2013 . The effects of VSE were dramatic. Patients who developed post-resuscitation shock in the VSE group had a 30% chance of survival to discharge compared to 0% in the control group. The rate of survival with good neurological outcome was tripled. Results of this quality are unheard of in patients who experience cardiac arrest. The VSE protocol was given IIb recommendation in the 2015 ACLS guidelines . VSE has everything that the vitamin C + steroid protocol has – cheap drugs, dramatic effect, low risk of side effects. PLUS VSE has two RCTs. Yet VSE is not widely adopted.

The number of treatment units (subjects or groups of subjects) assigned to control and treatment groups, affects an RCT's reliability. If the effect of the treatment is small, the number of treatment units in either group may be insufficient for rejecting the null hypothesis in the respective statistical test . The failure to reject the null hypothesis would imply that the treatment shows no statistically significant effect on the treated in a given test . But as the sample size increases, the same RCT may be able to demonstrate a significant effect of the treatment, even if this effect is small. [49]

What is equipoise in rct

what is equipoise in rct

The number of treatment units (subjects or groups of subjects) assigned to control and treatment groups, affects an RCT's reliability. If the effect of the treatment is small, the number of treatment units in either group may be insufficient for rejecting the null hypothesis in the respective statistical test . The failure to reject the null hypothesis would imply that the treatment shows no statistically significant effect on the treated in a given test . But as the sample size increases, the same RCT may be able to demonstrate a significant effect of the treatment, even if this effect is small. [49]

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