The Results of Randomized Controlled Trials in Emergency Medicine Are Frequently Fragile

Application of the Reverse Fragility Index to Statistically Nonsignificant Randomized Clinical Trial Results

“…Of the 2521 potentially relevant studies identified, 167 RCTs (7%) met the eligibility criteria (eTable in the Supplement); Figure 1 shows the literature search strategy. [5][6][7][8][9][10][11][12][13]; P = .34), and time-to-event primary end points vs frequency data (9 [5][6][7][8][9][10][11][12][13][14] vs 7 [4][5][6][7][8][9][10][11][12][13]; P = .43) ( Table 3).…”

“…The median (IQR) RFI at the P = .01 threshold was 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and at the P = .005 threshold was 14…”

Frequent fragility of randomized controlled trials for HCC treatment

“…To the best of our knowledge, FI investigation for HCC trials has not been performed. The FI has been evaluated in other RCTs, such as emergency medicine [11], giant cell arteritis, Clinical Practice Guidelines [12], and cardiac surgery field [13]. These studies consistently show that many RCTs are fragile, and several researchers have recommended that FI should be adopted in reporting clinical trial outcomes [12,14], our study showed that most results from the randomized trials were far more fragile.…”

Frequent fragility of randomized controlled trials for HCC treatment

“…To the best of our knowledge, FI investigation for HCC trials has not been performed. The FI has been evaluated in other RCTs, such as emergency medicine 17 , giant cell arteritis 18 , and Clinical Practice Guidelines 19 . These studies consistently show that many RCTs are fragile, and several researchers have recommended that FI should be adopted in reporting clinical trial outcomes 18,19 , our study showed that most results from the randomized trials were far more fragile.…”