Abstract
This chapter begins by outlining the theoretical requirements which must be fulfilled in an adequate evaluation of any medical intervention. The Randomised Control Trial (RCT) fulfils these requirements. The power of this experimental design in overcoming methodological difficulties, and its consequent value in assessing alternative clinical interventions are summarized. There are, however, important differences between the paradigms in medicine, where the RCT has been most extensively used and developed, and its use in evaluating psychiatric care. These differences are due to the nature of that which is being evaluated, and they produce both conceptual and technical problems in using the RCT design.
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References
Andrews G (1989) Evaluating Treatment Effectiveness. Australian and New Zealand Journal of Psychiatry 23:186
Braun P, Kochansky G, Shapiro R, Greenberg S, Gudeman JE, Johnson S, Shore MP (1981) Overview: Deinstitutionalisation of Psychiatric Patients, A Critical Review of Outcome Studies. American Journal of Psychiatry, 138 (6): 736–749
Brewin C, Bradley C (1989) Patient preferences and randomised controlled trials. British Medical Journal 299: 313–315
Burns T, Beadsmoore A, Bhat AV, Oliver A, Mathers C (1993) A Controlled Trial of Home-Based Acute Psychiatric Services. I: Clinical and Social Outcome. British Journal of Psychiatry 163: 49–54
Clarke RVG, Cornish DB (1972) The Controlled Trial in Institutional Research — paradigm or pitfall for penai evaluators. London: HMSO
Creed F, Black D, Anthony P et al (1989) Day Hospital and Community Treatment for Acute Psychiatric Illness. A Critical Appraisal. British Journal of Psychiatry 154: 300–310
Creed F, Black D, Anthony P et al (1990) Randomised Controlled Trial of Day Patient Versus Inpatient Psychiatric Treatment. British Medical Journal 300:1033–1037
Dean C, Phillips J, Gadd EM, Jospeh M, England S (1993) Comparison of community based service with hospital based service for people with acute, severe psychiatric illness. British Medical Journal 307: 473–476
Dick P, Cameron L, Cohen D, Barlow M, Ince A (1985) Day and Full Time Psychiatric Treatment: A controlled comparison. British Journal of Psychiatry, 147, 246–250
Goldberg D (1991) Cost effectiveness studies in the treatment of schizophrenia: A review. Social Psychiatry and Psychiatric Epidemiology, 26, 139–142
Haftier H, an der Heiden W (1991) Evaluating Effectiveness and Cost of Community Care for Schizophrenic Patients. Schizophrenia Bulletin, 17(3) 441–451
Hafher H, an der Heiden W (1989) The Evaluation of Mental Health Care Systems. British Journal of Psychiatry, 155, 12–17
Hoult J, Rosen A, Reynolds I (1984) Community Orientated Treatment Compared to Psychiatric Hospital Orientated Treatment. Soc Sci Med 18(11) 1002–1010
Kiesler CA (1982) Mental hospitals and alternative care: non institutionalisation as a potential public policy for mental patients. American Psychologist, 37, 349–360
Korn EL, Baumrind S (1991) Randomised clinical trials with clinician-preferred treatment. The Lancet, 337, 149–153
Kraemer HC, Pruyn JP (1990) The Evaluation of Different Approaches to Randomized Clinical Trials. Archives of General Psychiatry, 47, 1163–1169
Leber P (1991) The Future of Controlled Clinical Trials. Psychopharmacology Bulletin, 27(1) 3–8
Muijen M, Marks I, Connolly J, Audini B (1992) Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749–754
Newell DJ (1992) Intention-to-Treat Analysis: Implications for Quantitative and Qualitative Research. Int J Epidemiol 21(5) 837–841
Newcome RG (1988) Evaluation of treatment Effectiveness in Psychiatric Research. British Journal of Psychiatry, 152, 696–697
Oliver JPJ (1991) The Social Care Directive: Development of a Quality of Life Profile for Use in Community services for the Mentally 111. Social Work and Social Sciences Review 3(1) 5–45
Pasamanick B, Scarpitti FR, Dinitz S (1967) Schizophrenics in the community: An experimental study in the prevention of hospitalisation. New York Appleton Century Crofts
Piatt SD, Knights AC, Hirsch SR (1980) Caution and conservatism in the use of psychiatric day hospital: evidence from a research project that failed. Psychiatry Research, 3.123–132
Pocock SJ (1983) Clinical Trials: A Practical Approach. New York: Wiley
Ruggeri M, DallAgnola R (1993) The development and use of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS) for measuring expectations and satisfaction with community-based psychiatric services in patients, relatives and professionals. Psychological Medicine, 23, 511–524
Stein LI, Test MA (1980) Alternative to Mental Hospital Treatment: 1. Conceptual model, treatment program and clinical evaluation. Archives of General Psychiatry, 37, 392–397
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© 1996 Springer-Verlag Berlin Heidelberg
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Taylor, R., Thornicroft, G. (1996). Uses and Limits of Randomised Controlled Trials in Mental Health Service Research. In: Thornicroft, G., Tansella, M. (eds) Mental Health Outcome Measures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80202-7_11
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DOI: https://doi.org/10.1007/978-3-642-80202-7_11
Publisher Name: Springer, Berlin, Heidelberg
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