Throughout history, much of medical science has been based largely on observation. In recent decades, evidence-based medicine, which is defined as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients,”1 has shifted the ideal for how we practice medicine. Whereas observational research has proven to be useful in the past, it is now accepted that the opportunity for bias and confounding decreases with certain methodologic research designs, offering greater internal and external validity than mere observation.


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