Against a priori judgements of bad methodology: Questioning double-blinding as a universal methodological virtue of clinical trials
|Abstract||The feature of being ‘double blind’, where neither patients nor physicians are aware of who receives the experimental treatment, is universally trumpeted as being a virtue of clinical trials. The rationale for this view is unobjectionable: double blinding rules out the potential confounding influences of patient and physician beliefs. Nonetheless, viewing successfully double blind trials as necessarily superior leads to the paradox that very effective experimental treatments will not be supportable by best (double-blind) evidence. It seems strange that an account of evidence should make a priori judgments that certain claims can never be supported by ‘best evidence’. So far as treatments with large effects go, the claim that they are effective is highly testable and intuitively they should receive greater support from the evidence. In this paper I argue that the two potential confounders ruled out by double blinding are often not actual confounders outside placebo controlled trials of treatments with mild effects and that have subjective outcome measures.|
|Keywords||No keywords specified (fix it)|
|Categories||No categories specified (fix it)|
|Through your library||Only published papers are available at libraries|
Similar books and articles
Baruch A. Brody, Nancy Dickey, Susan S. Ellenberg, Robert P. Heaney, Robert J. Levine, Richard L. O'Brien, Ruth B. Purtilo & Charles Weijer, Is the Use of Placebo Controls Ethically Permissible in Clinical Trials of Agents Intended to Reduce Fractures in Osteoporosis?
James A. Anderson (2006). The Ethics and Science of Placebo-Controlled Trials: Assay Sensitivity and the Duhem-Quine Thesis. Journal of Medicine and Philosophy 31 (1):65 – 81.
N. Waller Bruce (1995). Individual Autonomy and the Double-Blind Controlled Experiment: The Case of Desperate Volunteers. Journal of Medicine and Philosophy 20 (1).
Erik Malmqvist, Niklas Juth, Niels Lynöe & Gert Helgesson (2011). Early Stopping of Clinical Trials: Charting the Ethical Terrain. Kennedy Institute of Ethics Journal 21 (1).
Stephen Wear (1995). A Desperate Solution: Individual Autonomy and the Double-Blind Controlled Experiment. Journal of Medicine and Philosophy 20 (1).
Piotr Zaborowski & Adam Górski (2004). Informed Consent and the Use of Placebo in Poland: Ethical and Legal Aspects. Science and Engineering Ethics 10 (1).
Stanisław Pużyński (2004). Placebo in the Investigation of Psychotropic Drugs, Especially Antidepressants. Science and Engineering Ethics 10 (1).
Franklin G. Miller & Howard Brody (2002). What Makes Placebo-Controlled Trials Unethical? American Journal of Bioethics 2 (2):3 – 9.
Jeremy Howick (2011). The Philosophy of Evidence-Based Medicine. Wiley-Blackwell, Bmj Books.
Added to index2009-01-28
Total downloads39 ( #29,796 of 549,065 )
Recent downloads (6 months)2 ( #37,252 of 549,065 )
How can I increase my downloads?