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A cognitive and methodological bias that overvalues findings from randomized controlled trials while undervaluing evidence from other study designs (observational studies, case studies, mechanistic reasoning, qualitative research). RCT bias treats RCTs as the sole gold standard, ignoring their limitations: limited external validity, inability to study rare events, ethical constraints, and the fact that many research questions cannot be randomized. This bias leads to evidence hierarchies that dismiss useful knowledge and to policies that demand RCT evidence even when none exists or when RCTs are inappropriate. It is a form of methodological fetishism that confuses a tool with the answer.
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