Ionannidis captures nicely the potential that: "Eventually, randomized controlled trials could be the pride of clinical investigators who collaborate in research that matters, and the best source of information on how to improve health."
I am sad that towards the end of a career in general internal medicine, I have not had the opportunity to enrol patients in practical and intellectually honest trials relating to important clinical questions. When the odd patient was enrolled with my "permission", if not endorsement, the trials were obviously intended for marketing purposes, rather than to learn the best treatment. The more I learned about most trials of drug therapy over the last 20 years, the less enthusiastic I became about encouraging anyone to participate, and the more sceptical that I could believe the conclusions or implement the recommendations.
Imagine what achieving genuinely open access to anonymized data, trial protocols, statistical analysis plans, and the characterization and adjudication of clinically meaningful outcomes would achieve. I am probably not the only physician who would more comfortably encourage patient participation in RCTs. I can even imagine granting informed consent myself!
Competing interests:
No competing interests
03 January 2015
Thomas L. Perry
physician
Dept. of Anaesthesiology, Pharmacology & Therapeutics, University of B.C.
Rapid Response:
Ionannidis captures nicely the potential that: "Eventually, randomized controlled trials could be the pride of clinical investigators who collaborate in research that matters, and the best source of information on how to improve health."
I am sad that towards the end of a career in general internal medicine, I have not had the opportunity to enrol patients in practical and intellectually honest trials relating to important clinical questions. When the odd patient was enrolled with my "permission", if not endorsement, the trials were obviously intended for marketing purposes, rather than to learn the best treatment. The more I learned about most trials of drug therapy over the last 20 years, the less enthusiastic I became about encouraging anyone to participate, and the more sceptical that I could believe the conclusions or implement the recommendations.
Imagine what achieving genuinely open access to anonymized data, trial protocols, statistical analysis plans, and the characterization and adjudication of clinically meaningful outcomes would achieve. I am probably not the only physician who would more comfortably encourage patient participation in RCTs. I can even imagine granting informed consent myself!
Competing interests: No competing interests