English

A Practical Guide to Interpret a Randomized Controlled Trial

Methodology 2026-04-13 v1

Abstract

The most dangerous error in clinical trial interpretation is equating p > 0.05 with no effect. This review provides a practical, algorithm-based framework for classifying randomized controlled trial (RCT) results into six distinct categories positive, imprecise (+), neutral, inconclusive, negative, and harmful using confidence interval (CI) position relative to the minimal clinically important difference (MCID) as the primary tool, augmented by Bayesian posterior probabilities. We demonstrate that the same p > 0.05 result can represent three fundamentally different conclusions (inconclusive, negative, or neutral), show how Bayesian reanalysis can rescue benefit signals missed by frequentist thresholds, and illustrate the framework with real-world examples from critical care and cardiology trials. The framework synthesizes guidance from Altman, Harrell, Pocock, Zampieri, the ASA, and ICH E9 into a single coherent decision algorithm.

Keywords

Cite

@article{arxiv.2604.09108,
  title  = {A Practical Guide to Interpret a Randomized Controlled Trial},
  author = {Ibrahim Halil Tanboga},
  journal= {arXiv preprint arXiv:2604.09108},
  year   = {2026}
}
R2 v1 2026-07-01T12:02:36.806Z