Promising health studies often don’t pan out in reality. The reasons are many. Research participants are usually different from general patients; their treatment doesn’t match real-world practice; researchers can devote resources not available in most physician offices.
Moreover, most studies, even the gold standard of randomized controlled trials, focus squarely on causality. They are set up to see if a treatment will work in optimal conditions, what scientists call efficacy. They’re “explanatory.”
Efficacy is important. But what we also need are studies that test if a treatment will work in the real world — if they have effectiveness. These different kinds of studies actually exist. They are called pragmatic trials, and a recent one might have helped serve as a brake as the opioid epidemic accelerated. That’s the topic of this week’s HCT.
This episode was adapted from a column I wrote for the Upshot. Links to sources can be found there.
