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In a provocative statement in a very recent issue of the American Journal of Preventive Medicine, Kessler and Glasgow have called for a 10-year moratorium on efficacy randomised controlled trials (RCTs) in health and health services research.1 The authors argue that much intervention research has had minimal impact on both policy and practice because the very nature of efficacy studies means that focus has had to be on a limited number of specific causal and preventive factors; this ignores both the complexity of real-world implementation and the multilevel ecological context in which interventions need to be conducted. I have also previously discussed those same limitations as they apply to sports injury prevention studies,2 3 most recently as part of my keynote address at the 2011 International Olympic Committee World Conference on The Prevention of Injury and Illness in Sport, to be published in a forthcoming issue of BJSM.4
Compared with other areas of medical and behavioural research, sports medicine is in its infancy and intervention research of any a kind, efficacy or effectiveness, is relatively scarce, though the former dominates.5 It would not, therefore, be appropriate to halt all sports medicine efficacy studies or those using RCT designs. Recent reviews in BJSM have highlighted clear gaps in current knowledge that could be useful for the prioritising of such work.6 7
Other types of intervention research
Having said this, there is no doubt that unless we fully embrace the challenges of conducting implementation and translation/dissemination studies, our sports medicine prevention efforts …