Quality of randomised controlled trials

Editor—I agree with Vlassov's comments on the paper by del Giglio and Costa (previous letter).¹ Research articles must be read with a critical eye, and it should not be assumed that high quality methods have been followed.

To assume that the protocol for a trial was followed exactly is dangerous, especially when the report does not reflect this. At what point does the assumption of good quality stop? It is often said that critical appraisals of articles are performed blinded to the authors, their institutions, and the publisher so that the report is read purely for its own merit.

I am also concerned that reviewers should contact trialists for original protocols. Although this is always good practice to clarify any uncertainities, it is time consuming and costly. The grants available for systematic reviews and meta-analyses do not tend to include enough money or time to make this a practical solution to the problem. Instead, the emphasis should be placed on high quality reporting so that all of the pertinent information is placed accurately in the report. This is the most practical way of making systematic reviews feasible and accurate.