Traumatic brain injury rehabilitation: Are there alternatives to randomized clinical trials?

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Article discusses the feasibility of using observational studies as an alternative to randomized clinical trials (RCTs) for assessing the effectiveness of traumatic brain injury (TBI) rehabilitation. While RCTs have been regarded as the gold standard for evidence of treatment efficacy, ethical, scientific, and resource factors may limit the expansion of needed trials. An attempt to apply an observational design to assess the relative effectiveness of inpatient rehabilitation versus home discharge failed to control for important confounding factors. However, observational designs may be successfully applied when regional or temporal variations in care are studied.

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