--- title: "Bayesian vs trad methods to analyze clinical trials | Sutter Health" description: "Choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of common non-specific therapeutic benefits." url: "https://www.sutterhealth.org/research/publications/bayesian-vs-trad-methods-to-analyze-clinical-trials-1055312637" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Bayesian vs trad methods to analyze clinical trials # A comparison of two worlds: How does Bayes hold up to the status quo for the analysis of clinical trials? Pressman AR, Avins AL, Hubbard A, & Satariano WA. _Contemp Clin Trials. 32(4):561-8. doi: 10.1016/j.cct.2011.03.010. Epub 2011 Mar 29._ 2011-07-01 ## Abstract BACKGROUND: Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. METHODS: We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. RESULTS: We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. CONCLUSIONS: Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/21453792/) ## Research topics - [Biostatistics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Biostatistics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Comparison of dynamic block randomization and minimization in randomized trials: a simulation study.](https://www.sutterhealth.org/research/publications/block-randomization-minimization-randomized-trials-1055312663) Xiao L, Lavori PW, Wilson SR, Ma J. Clin Trials. 8(1):59-69. doi: 10.1177/1740774510391683. 2011 Feb 01 - Publication ### [Algorithm for balancing both continuous and categorical covariates in randomized controlled trials](https://www.sutterhealth.org/research/publications/algorithm-balancing-covariates-rcts-1055312558) Xiao L, Yank V, Ma J. Comput Methods Programs Biomed. 108(3):1185-90. doi: 10.1016/j.cmpb.2012.06.001. Epub 2012 Jun 22. 2012 Dec 01 - Publication ### [Bar charts enhance Bland-Altman plots when value ranges are limited.](https://www.sutterhealth.org/research/publications/bar-charts-enhance-bland-altman-plots-1055312551) Smith MW, Ma J, Stafford RS. J Clin Epidemiol. 63(2):180-4. doi: 10.1016/j.jclinepi.2009.06.001. Epub 2009 Aug 27. 2010 Feb 01 - Publication ### [An easily accessible web-based minimization random allocation system for clinical trials.](https://www.sutterhealth.org/research/publications/web-based-minimization-random-allocation-1055312845) Xiao L, Huang Q, Yank V, Ma J. J Med Internet Res. 15(7):e139. 2013 Jul 01 - Publication ### [Minimran: a robust online system to implement minimization in randomized clinical trials.](https://www.sutterhealth.org/research/publications/minimran-online-do-minimization-rct-1055312971) Xiao L, Ma J. JSM Proc Biopharm Section. Alexandria VA: American Statistical Association 2014; 1094-1100. 2014 Aug 06 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/bayesian-vs-trad-methods-to-analyze-clinical-trials-1055312637#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Bayesian vs trad methods to analyze clinical trials"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/bayesian-vs-trad-methods-to-analyze-clinical-trials-1055312637#medicalscholarlyarticle","name":"A comparison of two worlds: How does Bayes hold up to the status quo for the analysis of clinical trials?","headline":"Bayesian vs trad methods to analyze clinical trials","abstract":"BACKGROUND: Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. METHODS: We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. RESULTS: We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. CONCLUSIONS: Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. 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