A System for Rapidly Yet Rigorously Evaluating the Quality of Randomized Controlled Trials

Abstract

This tutorial describes a system for rapidly yet rigorously assessing the quality of randomized controlled trials (RCTs). The system has 7 criteria, represented by the acronym “BIS FOES.” The BIS FOES system directs readers to assess RCTs based on the following 7 criteria: the RCT's use (or not) of effective (1) Blinding; the RCT's use (or not) of (2) Intent-to-Treat Analysis; the RCT's (3) Size and other information reflecting the effectiveness of randomization; the amount of sample lost during (4) Follow-up; the (5) Outcomes examined by the RCT (specifically, the outcome measures used by the RCT), the (6) Efects reported (ie, the statistical and clinical significance of the RCT's primary, secondary, and safety findings), and any (7) Special Considerations (ie, additional strengths, limitations, or notable features of the RCT). The first 6 criteria are of basic importance to the assessment of every RCT, whereas the Special Considerations criteria allows the system to be expanded to include virtually any other important aspect of the RCT. This tutorial explains the importance of these criteria and how to assess them. This tutorial also describes how many BIS FOES criteria can be initially assessed from the RCT Abstract while also directing readers to specific locations in the RCT article where additional important information can be found. We hope that the BIS FOES system will help healthcare trainees, but also potentially clinicians, researchers, and the general public, rapidly and thoroughly assess RCTs.

Evaluating the Quality of Randomized Controlled Trials

“…To keep up-to-date on advances in psychopharmacology, we read the peer-reviewed medical literature and in particular, the results of randomized, controlled clinical trials (RCTs). That is why the tutorial by Smith and Grigorian 1 in this issue is a must read for all practitioners, journal peer reviewers, clinical researchers, trainees, and students. The tutorial describes a 7-element system, known by the mnemonic “BIS FOES,” for rapidly yet rigorously assessing the quality of RCTs.…”