When gold standards are not so golden: prevalence bias in randomized trials endoscopic screening

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SUMMARY

    Randomized controlled trials (RCTs) are the gold standard approach to establish causality of preventive or therapeutic effects of medical interventions. In theory, in such a setting, the effectiveness of CRC prevention could still be assessed in a randomized design in which participants with findings of prevalent CRC at colonoscopy would be excluded and the remaining participants would be randomized in such a way that precancerous lesions would be removed in the intervention group only but not in the control group. The authors use the recently reported first RCT estimates of screening colonoscopy effects on . . .

     

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