Examination of Overall Treatment Effect and the Proportion Attributable to Contextual Effect in Osteoarthritis: Meta-Analysis of Randomised Controlled Trials The majority (75%) of the overall treatment effect in OA RCTs is attributable to contextual effects rather than the specific effect of treatments. Reporting overall treatment effect and PCE, in addition to traditional ES, permits a more balanced, clinically meaningful interpretation of RCT results. This would help dispel the frequent discordance between conclusions from RCT evidence and clinical experience-the 'efficacy paradox'.
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