The randomized controlled trial (RCT) is considered the gold standard study design in clinical and public health research. The Food and Drug Administration (FDA) requires numerous RCTs before approval of new drugs and devices. Systematic reviews or meta-analyses based on RCTs are considered the highest level of evidence by the U.S. Preventive Services Task Force (U.S. Preventive Services Task Force, 2013). Except under very unusual circumstances (Cluett & Burns, 2009), the Cochrane Collaboration allows only RCTs to be included in Cochrane Reviews (Higgins & Green, 2011). Large, well-conducted RCTs have at times changed clinical practice instantly upon publication (Ridker et al., 2005) because the evidence is so convincing.

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Bovbjerg ML.  On “Current Resources for Evidence-Based Practice”. [letter] Journal of Obstetric, Gynecologic, and Neonatal Nursing Sept/Oct 2010; 39(5): 501-2.