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Promising health studies often don’t pan out in reality. The reasons are many. Research participants are usually different from general patients; their treatment doesn’t match real-world practice; researchers can devote resources not available in most physician offices.

Moreover, most studies, even the gold standard of randomized controlled trials, focus squarely on causality. They are set up to see if a treatment will work in optimal conditions, what scientists call efficacy. They’re “explanatory.”

Efficacy is important. But what we also need are studies that test if a treatment will work in the real world — if they have effectiveness.

These different kinds of studies actually exist. They are called pragmatic trials, and a recent one might have helped serve as a brake as the opioid epidemic accelerated. That’s the topic of this week’s HCT.

This episode was adapted from a column Aaron wrote for the Upshot. Links to sources can be found there: https://goo.gl/LBFfiJ

***

Aaron has a book out now! It’s called The Bad Food Bible: How and Why to Eat Sinfully. You can order a copy now!!!

Amazon - http://amzn.to/2hGvhKw
Barnes & Noble - https://www.barnesandnoble.com/w/the-bad-food-bible-aaron-carroll/1125338472?ean=9780544952560
Indiebound - http://www.indiebound.org/book/9780544952560?aff=dhoom09
iBooks - http://itunes.apple.com/us/book?isbn=9780544952577&uo=8&at=1010lwmG
Google - http://books.google.com/books?vid=ISBN9780544952577
Kobo - http://www.kobobooks.com/search/search.html?q=9780544952577
Any local bookstore you might frequent. You can ask for the book by name or ISBN 978-0544952560

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