Critical Appraisal of Randomized Clinical Trials: Can We Have Faith in the Conclusions?

Randomized clinical trials (RCTs) are the most appropriate research design for studying the effectiveness of a specific intervention. Its results are considered as the highest 'level of evidence'. Published reports on RCTs have already succeeded in a peer review process, but still there can be undetected major deficiencies of the study that may question the reported outcome. It is still up to the readers to assess the quality of publications and to question if the published results apply to their patients. The major points of such a critical appraisal process are reviewed and discussed with a focus on breast cancer studies.