How Canada can better embed randomized trials into clinical care.

Murthy et al reflect on the capabilities of Canada to embed randomized trials into clinical care In an impressive scientific and organizational feat, researchers, health care workers and patients in the UK rapidly generated evidence that has transformed the care of patients with coronavirus disease 19 (COVID-19) worldwide In so, they have provided an example that Canada should emulate On Mar 19, 2020, a randomized trial called Randomized Evaluation of COVID-19 Therapy (RECOVERY) enrolled its first patient This UK study was designed to determine, among other things, whether dexamethasone is better than usual care without dexamethasone for patients admitted to hospital with COVID-19 Less than 4 months and 6,424 patient participants later, the results had been analyzed and released Dexamethasone significantly improved survival in the subset of patients who were sick enough to require supplemental oxygen or mechanical ventilation RECOVERY\u0027s results have influenced practice globally because they were convincing Randomization, which eliminates most confounding, ensured that the improvement seen was due to dexamethasone and not to differences in patient characteristics Moreover, the primary outcome was unequivocal;enough patients were randomly assigned to make the results credible