Indian Journal of Urology Users online:15316  
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Year : 2006  |  Volume : 22  |  Issue : 4  |  Page : 321


Senior Lecturer / Consultant Urologist, The Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, United Kingdom

Correspondence Address:
Robert S Pickard
Senior Lecturer / Consultant Urologist, The Freeman Hospital, Newcastle Upon Tyne, NE7 7DN
United Kingdom
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Pickard RS. Comments. Indian J Urol 2006;22:321

How to cite this URL:
Pickard RS. Comments. Indian J Urol [serial online] 2006 [cited 2022 Dec 4];22:321. Available from:

This is an important study which should be an inspiration to all urologists wherever they are working. Changes to established practice will only occur when there is overwhelming high quality evidence that the change is beneficial. One way of gathering this evidence is a large multi-centre randomised trial but this is hard to achieve without substantial external funding and supportive research infrastructure. Another way is by systematic review and meta-analysis of several smaller single institutional, but high-quality trials. The Authors of the present study should be congratulated on potentially contributing to this process as a result of their hard work in setting-up, running and most importantly completing and publishing their randomised trial. It is important to note however that RCTs are required to conform to a set of quality standards of conduct and reporting in order to be suitable for inclusion in meta-analysis. These standards are the CONSORT guidelines which are readily available ( In addition every RCT should be registered to bring it to the notice of researchers carrying out systematic review ( The results of the present study do confirm the findings of others suggesting that lower dose bacillus Calmette-Guerin

is as effective but better tolerated than standard dose. What we will need next is a meta-analysis of the pooled results from these studies to precipitate a change in practice.


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