Even if a study is adequately powered and undertaken with due regard for bias, a single trial may be difficult to apply to everyday practice. Participants

Most studies involve unusual participants. Frequently those eligible for trials have to give informed consent, their problems are well defined and do not involve multiple pathologies, and they are expected to tolerate the demands of a study.


Applying the results of a single study are made even more difficult because study interventions are often impractical. For example, drug trials may use rigid dose regimens impossible to apply to routine care. Psychosocial therapies tested within a trial are often of such high quality that they bear little resemblance to what an overstretched clinical service can provide.


Measurement of outcome may also limit the value of a single trial. In a survey of 2000 schizophrenia trials, 640 different scales were used to record outcomes such as mental state, behaviour, global impression, and side-effects.(4) Even within poorly powered trials, these sensitive tools may be able to detect real differences between treatments that may be statistically if not clinically significant. However, few clinicians use such scales in everyday practice and interpreting results becomes a matter of conjecture.

Trials that involve carefully defined groups of participants receiving meticulously controlled treatments and having outcomes measured on sensitive scales are called 'explanatory' studies.(Z) Such trials dominate the literature, although calls for more pragmatic or 'real world' methodology are increasing. (48) Currently, generalizing from the results of a single explanatory trial to day-to-day practice is inadvisable. If, however, several explanatory studies, all undertaken with constrained, but different, methodologies are giving a similar result, the clinician can feel a little more comfortable when acting on their findings.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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