Observational studies - should we simply ignore them in assessing transfusion outcomes?

© 2016 The Author(s).Background: As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study metho...

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Main Authors: Trentino, K., Farmer, Shannon, Gross, I., Shander, A., Isbister, J.
Format: Journal Article
Published: 2016
Online Access:http://hdl.handle.net/20.500.11937/58197
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author Trentino, K.
Farmer, Shannon
Gross, I.
Shander, A.
Isbister, J.
author_facet Trentino, K.
Farmer, Shannon
Gross, I.
Shander, A.
Isbister, J.
author_sort Trentino, K.
building Curtin Institutional Repository
collection Online Access
description © 2016 The Author(s).Background: As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elements of study design. A long-standing debate regarding findings of randomized controlled trials compared with those of observational studies, their strengths and limitations and questions regarding causal inference, has recently come into focus in relation to research assessing patient outcomes in transfusion medicine. Discussion: Observational studies are seen to have limitations that are largely avoided with randomized controlled trials, leading to the view that observational studies should not generally be used to inform practice. For example, observational studies examining patient outcomes associated with blood transfusion often present higher estimates of adverse outcomes than randomized controlled trials. Some have explained this difference as being a result of observational studies not properly adjusting for differences between patients transfused and those not transfused. However, one factor often overlooked, likely contributing to these variances between study methods is different exposure criteria. Another common to both study methods is exposure dose, specifically, measuring units transfused during only a part of the patient's hospital stay. Summary: When comparing the results of observational studies with randomized controlled trials assessing transfusion outcomes it is important that one consider not only the study method, but also the key elements of study design. Any study, regardless of its method, should focus on accurate measurement of the exposure and outcome variables of interest. Failure to do so may subject the study, regardless of its type, to bias and the need to interpret the results with caution.
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spelling curtin-20.500.11937-581972017-11-24T05:46:18Z Observational studies - should we simply ignore them in assessing transfusion outcomes? Trentino, K. Farmer, Shannon Gross, I. Shander, A. Isbister, J. © 2016 The Author(s).Background: As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elements of study design. A long-standing debate regarding findings of randomized controlled trials compared with those of observational studies, their strengths and limitations and questions regarding causal inference, has recently come into focus in relation to research assessing patient outcomes in transfusion medicine. Discussion: Observational studies are seen to have limitations that are largely avoided with randomized controlled trials, leading to the view that observational studies should not generally be used to inform practice. For example, observational studies examining patient outcomes associated with blood transfusion often present higher estimates of adverse outcomes than randomized controlled trials. Some have explained this difference as being a result of observational studies not properly adjusting for differences between patients transfused and those not transfused. However, one factor often overlooked, likely contributing to these variances between study methods is different exposure criteria. Another common to both study methods is exposure dose, specifically, measuring units transfused during only a part of the patient's hospital stay. Summary: When comparing the results of observational studies with randomized controlled trials assessing transfusion outcomes it is important that one consider not only the study method, but also the key elements of study design. Any study, regardless of its method, should focus on accurate measurement of the exposure and outcome variables of interest. Failure to do so may subject the study, regardless of its type, to bias and the need to interpret the results with caution. 2016 Journal Article http://hdl.handle.net/20.500.11937/58197 10.1186/s12871-016-0264-4 unknown
spellingShingle Trentino, K.
Farmer, Shannon
Gross, I.
Shander, A.
Isbister, J.
Observational studies - should we simply ignore them in assessing transfusion outcomes?
title Observational studies - should we simply ignore them in assessing transfusion outcomes?
title_full Observational studies - should we simply ignore them in assessing transfusion outcomes?
title_fullStr Observational studies - should we simply ignore them in assessing transfusion outcomes?
title_full_unstemmed Observational studies - should we simply ignore them in assessing transfusion outcomes?
title_short Observational studies - should we simply ignore them in assessing transfusion outcomes?
title_sort observational studies - should we simply ignore them in assessing transfusion outcomes?
url http://hdl.handle.net/20.500.11937/58197