Although prospective randomized trials are the gold standard for evidence in clinical
research, they usually are too costly and complicated to warrant their routine use
in addressing most questions in hand surgery. Nonrandomized study designs generally
are more feasible and although they provide less evidence than the prospective randomized
trial, well-planned investigations using these methodologies can be informative. The
key consideration for the clinical researcher is in recognizing the limitations of
each study design and asking an appropriate research question. This article reviews
some study designs that can be considered alternatives to randomized trials in evaluating
issues relating to treatment, prognosis, outcome, cause, and diagnosis in hand surgery.
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© 2005 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
