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The randomized clinical trial (RCT) approach is an ever-evolving compilation of strategies designed to minimize the probability of bias and to maximize the probability of reproducibility and the impact of the results. The genesis of the RCT is ancient, harking back to at least the controlled test of limes for scurvy prevention in the 1700s in the British Navy. A RCT done with only men does not produce results that necessarily generalize to women or children. The causal effect of treatment on a particular patient is defined as the difference in response when that patient is given the treatment versus when the patient is not. Researchers may simply miscalculate, for example, by doing power calculations based on the effect sizes they hope or expect to see, which are typically much more optimistic than the lower limit of clinical significance on which power calculations should be based.