ReportInfectious Disease

A meta-analysis of clinical studies conducted during the West Africa Ebola virus disease outbreak confirms the need for randomized control groups

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Science Translational Medicine  27 Nov 2019:
Vol. 11, Issue 520, eaaw1049
DOI: 10.1126/scitranslmed.aaw1049

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The importance of randomization

Conclusive evidence from clinical studies about treatment efficacy requires an appropriate control group, usually requiring randomization to balance out factors. During fatal disease outbreaks, randomization may be difficult to conduct due to ethical concerns and challenging field conditions. Dodd et al. have now performed a meta-analysis of six clinical studies conducted during the West Africa Ebola virus disease outbreak. These authors examined whether statistical modeling of multiple cohorts from these studies would facilitate a reasonable comparator for experimental treatments in future clinical studies lacking a randomized control group. The meta-analysis revealed considerable heterogeneity in the different control groups, which was not removed after statistical modeling. This suggests that nonrandomized control group data cannot be used as a comparator.

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