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A student presented the STAR*D study on depression today in journal club. These types of studies are referred to as “practical trials” or “effectiveness trials.” I confess that this is the first time that I have come across this study design. I asked questions about how they would compare this type of study to a prospective cohort, what they thought about the lack of control groups, what they thought about the randomization - or lack there of - etc. Mostly I heard that they loved this study design because it is "real." They seemed to value this design over an RCT because it draws from patients with comorbidities and who self-select a treatment arm, as opposed to RCTs that are careful to eliminate comorbidities and use proper randomization. Are there any guidelines for evaluating these "effectiveness" trials? What are your thoughts about them? Thanks! Laura -- Laura K. Cousineau, MLS Director, Biomedical Libraries at Dartmouth Instructor, Department of Medicine Dana Biomedical Library / HB 6168 37 Dewey Field Road Hanover, NH 03755 603-650-1662 [log in to unmask]