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AAP Grand Rounds 18:26 (2007) Weighing the Evidence: Why Pay Attention to Study Design Types?
Critics of evidence-based medicine disparage the hierarchy of study designs, which places prospective, randomized controlled trials (RCT) above retrospective designs such as cohort studies for determining best therapies.1 The article by Conway, et al in this issue on managing children with UTI is a retrospective (historical) cohort study. How much should we rely on its findings? When considering study design, the most important caveat is that a poorly performed study is unlikely to be useful, regardless of its place in the study design hierarchy. However, is the excellent Conway study likely to be inferior to a well-designed RCT? My answer is yes, and I believe Conway, et
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