Deviations from intention-to-treat in trials and reviews

What is it about?

Systematic reviews that include trials that deviate from intention-to-treat are significantly associated with placebo use and pharmacological interventions. Randomised trials that deviated from intention-to-treat are associated with post-randomisation exclusions, positive findings and industry sponsorship, as well as authors’ conflict of interest.

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Why is it important?

Deviation from intention-to-treat, in randomised controlled trials, is a widespread phenomenon that significantly affects systematic reviews. Greater effort is needed to avoid deviation from the intention-to-treat approach in randomised trials.