BMJ  2003;327:105 (12 July), doi:10.1136/bmj.327.7406.105

Letter

Reply to letters on ethics of trials from bayesian perspective

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

EDITOR—In response to my paper Kunkler disagrees that telling people emphatically that "the best treatment is unknown" suppresses sophisticated questioning by the patient.^{1 2} But this was not my opinion: I was merely quoting what Donovan et al reported in their original paper.³ I was therefore pleased that instead of following Donovan et al's injunction to be unequivocal about uncertainty Hamdy et al give those invited to the ProtecT study "precise information on risks and benefits of treatments based on current evidence for particular tumours."²

Yet Frankel et al describe such "prior" information not by the conventional term belief but by the pejorative term prejudice.² From global warming to the chance of rain tomorrow we form stronger or weaker beliefs, and it is perfectly rational to use these in decision making, even when the evidence falls short of proof. So, Hamdy et al are quite right to vary what . . . [Full text of this article]

Department of Public Health and Epidemiology, Public Health Building, University of Birmingham, Birmingham B15 2TT r.j.lilford@bham.ac.uk

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Ethics of clinical trials from bayesian perspective: Randomisation to clinical trials may solve dilemma of treatment choice in prostate cancer

Freddie C Hamdy, Jenny L Donovan, J Athene Lane, and David E Neal
BMJ 2003 326: 1456. [Extract] [Full Text] [PDF]

Ethics of clinical trials from a bayesian and decision analytic perspective: whose equipoise is it anyway?

Richard J Lilford
BMJ 2003 326: 980-981. [Extract] [Full Text] [PDF]

Quality improvement report: Improving design and conduct of randomised trials by embedding them in qualitative research: ProtecT (prostate testing for cancer and treatment) study • Commentary: presenting unbiased information to patients can be difficult

Jenny Donovan, Nicola Mills, Monica Smith, Lucy Brindle, Ann Jacoby, Tim Peters, Stephen Frankel, David Neal, Freddie Hamdy, and Paul Little
BMJ 2002 325: 766-770. [Abstract] [Full Text] [PDF]

Online poll

Find out more here>> and here>>