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study vs trial

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Posted 12/8/2013 4:35 PM (GMT 0)
First of all I don't know much about it but do know a trial is more conclusive than a study. I was hoping with this thread someone with knowledge would explain the differences, advantages, disadvantages of both, so the forum members could make more informed decisions based on the two. This is merely a hope and am not pressuring anyone to do it. The latest post on grape seeds prompted this hope. My son who just received a Doctorate in Epidemiology from Chapel Hill with a sports injury emphasis. He just got a job with the NCAA involved in sports,brain injure, but I digress. Ok Im bragging about my son. He says a mantra of epidemiologists is " all studies are wrong " I think I understand the logic of that statement. So there it is for your consideration.
Posted 12/8/2013 5:13 PM (GMT 0)
A study is done at a university while a trial is done at the court house...
Posted 12/8/2013 5:18 PM (GMT 0)
I use the word "study" as the more general term. A study can be a retrospective data analysis, a meta-analysis, a case-matched study, a cohort study, an epidemiological study, an in-vitro or in vivo lab trial, a clinical trial, etc. "Trial" is a more specific term -- it indicates that something was tried (e.g., a diagnostic technique, a prevention, an intervention, a therapy). They all serve a purpose.

- Allen
Posted 12/8/2013 6:47 PM (GMT 0)
Would the evidence of a study be more in line with a civil trial, while the evidence in a clinical trial be more in line with a criminal trial? And which one gives the more definitive guide to what a patient should do/think reference their own situation in your opinion. I have heard that a clinical trial is hard evidence vs a study which is less so, but Im not sure why that is the case. I appreciate any thoughts on this. Would the less so, explain the various studies that come and go, that seemingly contradict each other. coffee good for you/coffee not good for you, reference the heart,say. Another way of putting it . Can a carefully monitored clinical trial contradict another carefully monitored clinical trial with the same methodology for both? Im off for a nice champagne brunch on the beach with my wife, and no she does not walk 7 paces behind me but spirit to spirit….. Not to make y'all jealous, just to lure you to our beautiful state. It ain't that expensive. As the song says " the road is long but the beauty there is worth it." Plus its the good old U.S.A.
Posted 12/8/2013 6:55 PM (GMT 0)
Would the evidence of a study be more in line with a civil trial, while the evidence in a clinical trial be more in line with a criminal trial?

I was thinking like hypothesis vs theory.

ed

 

Posted 12/9/2013 12:52 AM (GMT 0)
Ich mach nix Ed, not getten a lot of traction here, never matter, no mind or it is no matter never mind?? From the land of the whirligigs go I………..
Posted 12/9/2013 1:42 AM (GMT 0)
The purpose to run a retrospective study ~ to hypothesize a point.

The purpose to run a randomized clinical trial ~ to answer a question.

8 out of 9 retrospective studies fail to pass the test proposed by an RCT. In other words ~ 11% of studies are accurate and 100% of RCT's are accurate per the proportions provided.

The most troubling studies are single institution retrospective studies. They are riddled in bias, variation of protocol, and also lacking peer review.

The strengths in RC T's is that a question is asked, the parameters are set to make the comparison, and are peer reviewed (typically).

A well designed RCT result is fact. Any results from a study is hypothesis.

Tony
Posted 12/9/2013 2:02 AM (GMT 0)
Also keep in mind that there are various levels of research based on the following.

www.nih.gov/health/clinicaltrials/basics.htm

A retrospective study fails at many levels against these parameters. Many doctors can use sliding scales to establish success criteria that they publicize. But when you have full view of that sliding scale the results vary heavily and can be misleading. This shows the need for RCT's (Randomized Clinical Trials) with established end points to verify facts. And again the facts usually are not the advertised results from a study or they are but contain data that prove the studied method was not the best protocol.

My recommendation? Don't immerse into studies by single institutions. Always give credence to multi institutional RCT's.

Interesting facts:
53% of all physicians still practice methods that have been proven wrong in RCT's three years after the trial is complete.

RCT's are typically decried in their design but not their results.

Tony
Posted 12/9/2013 3:36 AM (GMT 0)
logo - I thought this was most excellent of questions to pose here. it's a subject that I know little if anything about, and was curious myself. was glad to see tony pitch in, would be right up his alley.

btw, sounds like your son has done well for himself, good reason to brag in my opinion

david
Posted 12/9/2013 3:49 AM (GMT 0)
TC, thanks for that great answer, It helps my understanding and others Im sure, so much.
Purgatory, thank you for your comments on the thread and about my son. Aloha to you both
Posted 12/9/2013 4:12 AM (GMT 0)
definitely helped me to understand the difference. great question, great answer.
Posted 12/9/2013 1:13 PM (GMT 0)
Great question there Logo, and equally great answer Tony. Thanks to you both!
Posted 12/9/2013 9:59 PM (GMT 0)
Your Epidemiologist son summarizes well that retrospective studies are heavily flawed, Logo. I guess I now understand that these types of studies tend to be marketing studies as opposed to producing better treatments. With RCT's it's the opposite. Usually within a trial there are additional studies performed but unless they are put into the question and there are defined end points the results of these types of studies are still hypothesis.

Having worked for a group that does these RCT's I now fully appreciate the need for them. They are much more accurate that taking a database of patient history and attempting to draw conclusions. Retrospective views do not hold up to prospective views because they can be manipulated. Using that sliding scale allows one to find the gaps to spin a point off of. That's ok as long as an RCT is done to confirm the findings but the problem is that the RCT seldom confirms data that was gathered in that way.

Congrats to your son. He is 100% correct. Retrospective studies are typically wrong in their conclusions.

Tony
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