FALLIBILITY OF CLINICAL RESEARCH

Though clinical research has resulted in an abundance of literature over the past 30 years, many of the same questions asked in 1960 are being asked today. Why is it seemingly impossible to determine the proper age for palate repair? Why does it seem impossible to determine if maxillary deficiency in patients with cleft lip and palate is caused by the surgeon or is intrinsic? Though poor design of clinical research is in part responsible, even well-designed clinical research findings can be misinterpreted, well-designed studies can be poorly executed, or important findings can be completely overlooked because of experimenter bias. It is even possible that clinical research is well designed and executed, but the question asked is the wrong question. Agreement on major issues may seem impossible, but experience in other fields of clinical research shows that the problem is not universal and our failure to agree may have a major impact on the application of patient care.