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J Clin Epidemiol. 1997 Feb;50(2):137-46.

Are community health interventions evaluated appropriately? A review of six journals.

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1
Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.

Abstract

OBJECTIVES:

To determine if Randomized Controlled Trial (RCT) methodology was used appropriately in community health, we: (1) determined the proportion of non-randomized studies that should have been RCTs, and (2) assessed the quality of the RCTs.

METHODS:

The 1992 issues of six community health journals were manually searched. Intervention studies were analyzed. Studies that did not use randomization were analyzed for feasibility and practicality of RCT methods; RCTs were analyzed for quality using a checklist. RCTs were compared with community health RCTs from The New England Journal of Medicine. The proportion of studies meeting each criterion was determined.

RESULTS:

Fourteen percent of 603 studies were interventions and 4% were RCTs. Of those not using randomization, 42% should have. Mean RCT scores were significantly lower for the community health journals than for The New England Journal of Medicine. Many criteria important to quality scored poorly.

CONCLUSIONS:

RCTs are underused and lack methodologic rigor in community health. Conclusions regarding the effectiveness of interventions are therefore suspect.

PMID:
9120506
[Indexed for MEDLINE]

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