Fool's Gold: Examining the Use of Gold Standards in the Production of Research Evidence
Author: Hyde, Paula
Source: The British Journal of Occupational Therapy, Volume 67, Number 2, 1 February 2004 , pp. 89-94(6)
Publisher: College of Occupational Therapists
Abstract:Research designs, and the methods that they dictate, normally arise from the nature of the questions being asked. However, in most medical research, a hierarchy of evidence is in common use that influences choice in favour of research designs that include methods with a higher ranking. The acceptance of superior research methods consequently limits the types of question that can be asked. The randomised controlled trial (RCT) has enjoyed a long reign as the gold standard in health research methodology. The RCT is used here as a case example of how hierarchies of research methods can distort the production of evidence relating to health care.
The acceptance of the RCT as a superior method in the hierarchy of evidence production has been promoted by claims that RCTs offer reliability, objectivity and levels of certainty about treatment effectiveness (inferred through statistical significances) that other methods do not. These statistical significances depend upon mathematical probabilities that imply a level of uncertainty. Mathematical significance has been confused with the substantive or practical importance of research results. The importance of research findings cannot be determined by hierarchies, nor by statistical techniques alone; other types of method can provide findings that are equally valid, true or useful to evidence production in occupational therapy.
Document Type: Research Article
Publication date: 2004-02-01
The British Journal of Occupational Therapy (BJOT) is the official journal of the College of Occupational Therapists. Its purpose is to publish articles relevant to theory, practice, research, education and management in occupational therapy internationally.
BJOT publishes research articles, critical reviews, practice analyses, opinion pieces, editorials, letters to the editor, book reviews and an annual index. Please refer to the author's guide at http://www.cot.co.uk/british-journal-bjot/british-journal-occupational-therapy
Submissions can be made at http://mc.manuscriptcentral.com/bjot
The 2012 Impact Factor for The British Journal of Occupational Therapy is 1.096.
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