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Risk, Chance, and CausationInvestigating the Origins and Treatment of Disease$
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Michael B. Bracken

Print publication date: 2013

Print ISBN-13: 9780300188844

Published to Yale Scholarship Online: October 2013

DOI: 10.12987/yale/9780300188844.001.0001

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PRINTED FROM YALE SCHOLARSHIP ONLINE (www.yale.universitypressscholarship.com). (c) Copyright Yale University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in YSO for personal use.date: 19 September 2021

More Trials and Some Tribulations

More Trials and Some Tribulations

(p.70) Five More Trials and Some Tribulations
Risk, Chance, and Causation

Michael B. Bracken

Yale University Press

This chapter presents and discusses a scenario wherein randomized clinical trials do not work. Some of the problems it looks at include patients discussing their experimental treatment with other patients who are in the control group, doctors prematurely adopting the experimental therapy, and the fact that the majority of trials do not show benefit from the experimental therapy. Some may abandon a trial altogether because of a lack of participants; in this case, the possible benefit to future patients is eliminated. The only way medicine can advance is through the conclusion of medical trials—be a trial a validation of a beneficial therapy or a non-beneficial or even harmful one. Where a randomized trial cannot be successful, a cluster trial may be an appropriate alternative. This is a trial design where an entire hospital, clinic, village, or even community is randomly selected so it can be treated in the experimental manner, and another hospital or community is selected to provide the control group.

Keywords:   randomized clinical trials, experimental therapy, control group, cluster trial, medical trials, beneficial therapy

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