Interpreting Clinical Trial Results

Randomized clinical trials (RCTs) are the gold standard to evaluate intervention efficacy and effectiveness. To apply current, evidence-based interventions to daily practice, it is imperative that practicing intensivists be able to interpret the results of individual RCTs in the context of their patients. In this article, we outline an approach to interpreting critical care RCTs from the perspective of the clinician that focuses on answering four questions: (1) Would my patient have been enrolled and represented in the RCT? (2) Is the intervention feasible? (3) Are there threats to the internal validity of the RCT results? (4) Are the RCT results meaningful? Answers to these four questions can be used to assist intensivists in deciding whether to apply RCT evidence to their patients at the bedside and to avoid common pitfalls of RCT interpretation.