In a number of cases, natural experiments are at least as powerful as randomized controlled trials, even with placebo control. Unfortunately, we’ve seen an uptick in calls for RCTs even when such trials would pose safety or ethical concerns, by prominent, eloquent physicians for reasons I can’t fully comprehend. We need to better understand when RCTs are required, and accept the natural experiments that can successfully be used — and cited — based on their statistical power.
In occupational medicine we see natural experiments that provide the best evidence of whether or not a chemical can cause diseases.
In a number of cases, natural experiments are at least as powerful as randomized controlled trials, even with placebo control. Unfortunately, we’ve seen an uptick in calls for RCTs even when such trials would pose safety or ethical concerns, by prominent, eloquent physicians for reasons I can’t fully comprehend. We need to better understand when RCTs are required, and accept the natural experiments that can successfully be used — and cited — based on their statistical power.