Why randomized controlled trials fail but needn't: 1. Failure to gain "coal-face" commitment and to use the uncertainty principle.
Year: 2000
Type: article
Abstract: My pager went off as I was half-dozing, half-reading the newspaper. Yuri Gagarin, born the same year as me, had just become the first man to orbit the earth; Nelson Mandela, not yet imprisoned, had gone underground; and John F. Kennedy had just signed the bill creating the Peace Corps. An hour later, back on the charity ward and feeling the effects of too much acrid coffee and too little sleep, achalasia hit me when I found the lancet-shaped diplococci in her sputum. It was 3 am and the research protocol, appearing unannounced on our workroom wall, declared that, as the front-line clinician (the British call this “working at the coal face”), I had to enter her into the trial. She was single, poor, the sole supporter of 3 children and now so sick af-ter 10 days of cough, fever and sputum that she’d risked losing her menial job by leaving it early to struggle through Chicago’s filthy March slush to our emergency room. My boss was testing one of the first synthetic penicillins against the then standard penicillin G in patients with pneumococcal pneu-
Source: Europe PMC (PubMed Central)
Author: D L Sackett
Language: English
Topic: Ethics in Clinical Research
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2129200857