Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP
Posting-Version: version B 2.10.3 alpha 4/15/85; site elsie.UUCP
Path: utzoo!decvax!genrad!panda!talcott!harvard!seismo!elsie!sck
From: sck@elsie.UUCP (Steve Kaufman)
Newsgroups: net.med,net.women
Subject: Re: Re: Breast Cancer Treatment.
Message-ID: <5180@elsie.UUCP>
Date: Wed, 24-Jul-85 15:25:06 EDT
Article-I.D.: elsie.5180
Posted: Wed Jul 24 15:25:06 1985
Date-Received: Thu, 25-Jul-85 17:45:44 EDT
References: <1765@aecom.UUCP> <1271@mnetor.UUCP> <560@ttidcc.UUCP> <1400@mnetor.UUCP>
Distribution: na
Organization: NIH-LEC, Bethesda, MD
Lines: 41

In article <1400@mnetor.UUCP>, sophie@mnetor.UUCP (Sophie Quigley) writes:
> ... most people have opinions on things, so I would assume that most
> doctors have an opinion on what they *think* is the best treatment for
> a particular disease for a particular person.
>  ...   So, doctors who
> encourage their patients to participate in such a study know that since
> treatments are assigned randomly, there is a chance that their patients
> will not be given as good a care as they might have given them had they
> done what they thought was best.  
> 
	With apologies to those who caught this the first time around,
	I think it's appropriate to re-post what I
	submitted 2 months ago on this subject
        (a quote from a recent book on clinical trials):

	"Presumably, the reason that a clinical trial is
	being considered at all is that there is uncertainty
        about the potential benefits of a new intervention.

	If an investigator believes --for whatever reason--
	that the new intervention is more beneficial or harmful than the old,
	he should not participate in the trial.

	If, on the other hand, he has sufficient doubt
        about which intervention is better,
        then he is ethically justified in participating in a
	randomized clinical trial to settle the question.
        ... under these circumstances, randomization is a more ethical way
	of practicing medicine than the routine prescribing of medication
	or therapy that has never been proven to be beneficial ...
	and could possibly be harmful." (pp. 31-2)

	"Of course, some results, such as the effectiveness of penicillin
	in pneumococcal pneumonia, are so highly dramatic than no comparison
	group is needed.  Successful results of this magnitude,
	however, are rare."   (p. 29)

		----excerpted from _Fundamentals_of_Clinical_Trials_
		by L. M. Friedman, C. D. Furberg, & D. L. DeMets
		(Wright, PSG, Inc: 1982  [I understand there's a 1985
		edition out now but haven't seen it yet])