Evaluating the importance of sham-controlled trials in the investigation of medical devices in interventional cardiology.

Byrne, Robert A; Capodanno, Davide; Mahfoud, Felix; Fajadet, Jean; Windecker, Stephan; Jüni, Peter; Baumbach, Andreas; Wijns, William; Haude, Michael (2018). Evaluating the importance of sham-controlled trials in the investigation of medical devices in interventional cardiology. EuroIntervention, 14(6), pp. 708-715. Europa Digital & Publishing 10.4244/EIJ-D-18-00481

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Cardiovascular medicine is one of the specialties that has relied most heavily on evidence from randomised clinical trials in determining best practice for the management of common disease conditions. When comparing treatment approaches, trials incorporating random allocation are the most appropriate method for protecting against treatment allocation bias. In order to protect against performance and ascertainment bias, trial designs including placebo control are preferable where feasible. In contrast to testing of medicines, treatments based on procedures or use of medical devices are more challenging to assess, as sham procedures are necessary to facilitate blinding of participants. However, in many cases, ethical concerns exist, as individual patients allocated to sham procedure are exposed only to risk without potential for benefit. Accordingly, the potential benefits to the general patient population must be carefully weighed against the risks of the exposed individuals. For this reason, trial design and study conduct are critically important to ensure that the investigation has the best chance of answering the study question at hand. In the current manuscript, we aim to review issues relating to the conduct of sham-controlled trials and discuss a number of recent examples in the field of interventional cardiology.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

14 Mar 2019 11:06

Last Modified:

14 Mar 2019 11:06

Publisher DOI:

10.4244/EIJ-D-18-00481

PubMed ID:

29786535

URI:

https://boris.unibe.ch/id/eprint/125905

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