Editing Randomized controlled trial (section)

=== Time and costs ===
RCTs can be expensive;<ref name="Sanson-Fisher-2007" /> one study found 28 [[Phase III clinical trials|Phase III]] RCTs funded by the [[National Institute of Neurological Disorders and Stroke]] prior to 2000 with a total cost of US$335 million,<ref name="Johnston-2006">{{Cite journal |vauthors=Johnston SC, Rootenberg JD, Katrak S, Smith WS, Elkins JS |date=April 2006 |title=Effect of a US National Institutes of Health programme of clinical trials on public health and costs |journal=Lancet |volume=367 |issue=9519 |pages=1319–1327 |doi=10.1016/S0140-6736(06)68578-4 |pmid=16631910 |s2cid=41035177}}</ref> for a [[mean]] cost of US$12 million per RCT.  Nevertheless, the [[return on investment]] of RCTs may be high, in that the same study projected that the 28 RCTs produced a "net benefit to society at 10-years" of 46 times the cost of the trials program, based on evaluating a [[quality-adjusted life year]] as equal to the prevailing mean [[per capita]] [[gross domestic product]].<ref name="Johnston-2006" />

The conduct of an RCT takes several years until being published; thus, data is restricted from the medical community for long years and may be of less relevance at time of publication.<ref name="CaseReport">{{Cite journal |vauthors=Yitschaky O, Yitschaky M, Zadik Y |date=May 2011 |title=Case report on trial: Do you, Doctor, swear to tell the truth, the whole truth and nothing but the truth? |journal=Journal of Medical Case Reports |volume=5 |issue=1 |page=179 |doi=10.1186/1752-1947-5-179 |pmc=3113995 |pmid=21569508 |doi-access=free}}</ref>

It is costly to maintain RCTs for the years or decades that would be ideal for evaluating some interventions.<ref name="Black-1996" /><ref name="Sanson-Fisher-2007" />

Interventions to prevent events that occur only infrequently (e.g., [[sudden infant death syndrome]]) and uncommon adverse outcomes (e.g., a rare side effect of a drug) would require RCTs with extremely large sample sizes and may, therefore, best be assessed by observational studies.<ref name="Black-1996" />

Due to the costs of running RCTs, these usually only inspect one variable or very few variables, rarely reflecting the full picture of a complicated medical situation; whereas the [[case report]], for example, can detail many aspects of the patient's [[medicine|medical]] situation (e.g. [[patient history]], [[physical examination]], [[diagnosis]], [[psychosocial]] aspects, follow up).<ref name="CaseReport" />