Clinical trials and "real-world" medicine

R John Simes
Med J Aust 2002; 177 (8): . || doi: 10.5694/j.1326-5377.2002.tb04880.x
Published online: 21 October 2002

Trial evidence best informs real-world medicine when it is relevant to the clinical problem

Controlled clinical trials provide the most reliable evidence of whether treatments are effective, particularly when the effects of treatment are moderate. Without such trials, ineffective treatments or, even worse, harmful interventions may be accepted in medical practice. Yet medical practice is often not based on clinical trial evidence, because the evidence is considered not relevant or does not exist. Real-world medicine must not only consider the effectiveness of specific treatments, but must do so in the context of patients who have multiple problems and who are often already receiving many different treatments in a setting different from that tested in the trial.1

  • R John Simes

  • NHMRC Clinical Trials Centre, Sydney, NSW.



I am grateful to Rhana Pike for editorial assistance and to Martin Stockler and Anthony Keech for helpful advice.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.