by What does a RCT tell us? Parachute use compared with a backpack control did not reduce death or major traumatic injury when used by participants jumping from aircraft in this first randomized evaluation of the intervention. This largely resulted from our ability to only recruit participants jumping from stationary aircraft on the ground. When beliefs regarding the effectiveness of an intervention exist in the community, randomized trials evaluating their effectiveness could selectively enroll individuals with a lower likelihood of benefit, thereby diminishing the applicability of trial results to routine practice. Therefore, although we can confidently recommend that individuals jumping from small stationary aircraft on the ground do not require
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Lars Pålsson Syll considers the following as important: Theory of Science & Methodology
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What does a RCT tell us?
Parachute use compared with a backpack control did not reduce death or major traumatic injury when used by participants jumping from aircraft in this first randomized evaluation of the intervention. This largely resulted from our ability to only recruit participants jumping from stationary aircraft on the ground. When beliefs regarding the effectiveness of an intervention exist in the community, randomized trials evaluating their effectiveness could selectively enroll individuals with a lower likelihood of benefit, thereby diminishing the applicability of trial results to routine practice. Therefore, although we can confidently recommend that individuals jumping from small stationary aircraft on the ground do not require parachutes, individual judgment should be exercised when applying these findings at higher altitudes.
Yeap — background knowledge sure is important when experimenting …
‘Ideally controlled experiments’ tell us with certainty what causes what effects — but only given the right ‘closures.’ Making appropriate extrapolations from (ideal, accidental, natural or quasi) experiments to different settings, populations or target systems, is not easy. ‘It works there’ is no evidence for ‘it will work here.’ Causes deduced in an experimental setting still have to show that they come with an export-warrant to the target population/system. The causal background assumptions made have to be justified, and without licenses to export, the value of ‘rigorous’ and ‘precise’ methods — and ‘on-average-knowledge’ — is despairingly small.
RCTs have very little reach beyond giving descriptions of what has happened in the past. From the perspective of the future and for policy purposes they are as a rule of limited value since they cannot tell us what background factors were held constant when the trial intervention was being made.
RCTs usually do not provide evidence that the results are exportable to other target systems. RCTs cannot be taken for granted to give generalizable results. That something works somewhere for someone is no warranty for us to believe it to work for us here or even that it works generally.