The randomised controlled trial in the evaluation of new technology: a case study.

Abstract

The randomised controlled trial in

Cost Effectiveness of Extracorporeal Shock Wave Lithotripsy and Percutaneous Nephrolithotomy for Medium-Sized Kidney Stones

“…Challah & Mays have discussed several factors that could make it difficult to mount a randomised trial (3), and the present study was only partly successful. The most important reasons for not taking part were fear of losing patients, budget restrictions, and lack of experience in PNL.…”

Preliminary results of a randomized controlled trial of prophylactic shock wave lithotripsy for small asymptomatic renal calyceal stones

“…The systematic assessment of the clinical efficacy, benefits and cost of ESWL in a randomized clinical trial was initially proposed in 1986. However, clinical opinion at that time considered this to be unethical because the treatment was already in widespread use and appeared superior to open surgery and PCNL [9]. Glowacki et al.…”

Consensus of lithotriptor terminology

“…Lithotripsy has been widely accepted by Urologists as a significant advance in the management of renal stone disease [7], but there has been considerable debate by health economists and public health physicians about the efficacy and cost effectiveness of this expensive technology [1]. Much of this debate continued through the mid1980s as a result of conflicting reports about ESWL and percutaneous nephrolithotomy (PCN) [5,11] and a review of presentations of world wide results of lithotripsy from different centres indicates a wide variation in the style of presentation and apparently varying results of treatment [8].…”