BMJ 1998;317:78 ( 4 July )

Letters

Incorporating patient preferences into clinical trials

    Information about patients' preference must be obtained first
    Merits of alternative strategies for incorporating patient preferences into clinical trials must be considered carefully
    Authors' reply

Information about patients' preference must be obtained first

The first 150 words of the full text of this article appear below.

EDITORTorgerson and Sibbald discuss the difficulties of assessing the relative merits of treatments when patients have strong preferences for one of the alternatives.¹ In these circumstances, however, patients should not be expected to participate in randomised comparisons, and neither should the professionals caring for them.

It is important to consider the bases of these preferences, particularly as there is a widespread and unsupported belief that new treatments are likely to be superior to existing alternatives.² For example, it seems that people with diabetes who were being recruited to a randomised comparison of insulin pumps with conventional management were left with the impression that pumps represented an important advance (C Bradley, personal communication). Not surprisingly, therefore, those allocated to pumps were pleased, while those allocated to conventional management were disappointed. Randomisation thus created comparison groups that were incomparable in these psychological characteristics, and this may have had implications for . . . [Full text of this article]

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