Don't Be Blinded by the Blinding.

Betensky, Rebecca A · NEJM Evid · 2022

editorial · Level V

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Abstract

Don't Be Blinded by the BlindingBlinding of participants and investigators is universally accepted as a critical component of a high-quality randomized clinical trial. In conjunction with random assignment, blinding protects against several potential sources of bias, such as selection of participants, compliance and adherence to the protocol, differential dropout, researcher and patient assessments of outcomes, application of ancillary and supportive treatment, dose adjustments, encouragement by clinicians, and follow-up actions such as seeking and prescribing diagnostic testing. Unfortunately, complete blinding is simply not possible for some clinical trials, including those for many surgical interventions.