Randomized controlled trials (RCTs) are considered the gold standard for medical evidence. However, RCTs typically exclude elderly patients, those with multiple conditions, and other 'complicated' cases—precisely the patients who often need treatment most. This creates a gap between trial populations and real-world patients. Some researchers advocate for pragmatic trials that include more representative populations, accepting some loss of experimental control.
It can be inferred from the text that
RCTs include all types of patients equally
elderly patients never need medical treatment
experimental control is unnecessary for medical research
optimizing for one research criterion may compromise another
Correct Answer: D
Choice D is the best answer. Including more patients means accepting "some loss of experimental control."
- Context clues: RCTs prioritize control but exclude representative patients; pragmatic trials include patients but sacrifice control.
- Meaning: There's a trade-off between generalizability and experimental rigor.
- Verify: "Accepting some loss" explicitly names the trade-off.
đź’ˇ Strategy: When improving one aspect requires sacrificing another, infer an inherent trade-off.
Choice A is incorrect because RCTs "exclude elderly patients, those with multiple conditions." Choice B is incorrect because they "often need treatment most." Choice C is incorrect because sacrificing "some" control is accepted, not all of it.