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Contemp Clin Trials. 2005 Oct;26(5):518-29.

Are certain multicenter randomized clinical trial structures misleading clinical and policy decisions?

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  • 1Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, #5717, Stanford, CA 94305, USA.


Multicenter studies involving randomized clinical trials (RCTs) may have different structures. We discuss four general types. The first two, an "ideal" multicenter RCT and decentralized multicenter collaborative RCTs, we feel are, in different circumstances, highly recommended approaches. The other two, the multicenter RCT that ignores site differences and centralized multicenter collaborative RCTs, we argue, are not only not cost-effective but may also produce misleading results, thus impeding scientific progress and possibly putting patients at unnecessary risk.

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