Also, maybe mention something about quality of outcomes vs. just ability to predict. If I give all my patients poison, then I can score very well on my outcome predictions.
The argument of getting better ‘outcomes’ by giving patients poison works similarly with clinical trials in our existing system. A drug company who uses a poison as a placebo or a badly dosed existing treatment as control is going to have their drug look better.
I don’t advocate that prediction scores alone should drive decisions but that they should be an important part of the debate and the debate should actually happen between experts that share their views on how things work.
Why would poison (or anything with a known negative effect) be used as a placebo?
Of course I understand the drug companies’ incentives, but I don’t get how that could be justified or look reasonably scientific. Do you have a specific example?
My main point is that the ability exists in both the existing system and also a prediction-based one.
But when it comes to justifying poison, imagine you have a drug that gives everybody nausia after they take it. You have to tell your trial participants because of informed consent that everybody who gets verum will very likely get nausia soon after taking it.
You can justify giving the patients in the placebo group a poison that causes nausia because otherwise all the patients know whether or not they got the placebo.
Many studies don’t specify what they are using as placebo.
I do remember cases where someone argued that the dose of the control group was likely net negative but don’t have specific links right now.
I think his point is that the same failure state Measure mentioned, doctors giving patients poison and correctly predicting outcomes, is just as likely as for the current clinical trial scheme.
Also, maybe mention something about quality of outcomes vs. just ability to predict. If I give all my patients poison, then I can score very well on my outcome predictions.
The argument of getting better ‘outcomes’ by giving patients poison works similarly with clinical trials in our existing system. A drug company who uses a poison as a placebo or a badly dosed existing treatment as control is going to have their drug look better.
I don’t advocate that prediction scores alone should drive decisions but that they should be an important part of the debate and the debate should actually happen between experts that share their views on how things work.
Why would poison (or anything with a known negative effect) be used as a placebo?
Of course I understand the drug companies’ incentives, but I don’t get how that could be justified or look reasonably scientific. Do you have a specific example?
My main point is that the ability exists in both the existing system and also a prediction-based one.
But when it comes to justifying poison, imagine you have a drug that gives everybody nausia after they take it. You have to tell your trial participants because of informed consent that everybody who gets verum will very likely get nausia soon after taking it.
You can justify giving the patients in the placebo group a poison that causes nausia because otherwise all the patients know whether or not they got the placebo.
Many studies don’t specify what they are using as placebo.
I do remember cases where someone argued that the dose of the control group was likely net negative but don’t have specific links right now.
I think his point is that the same failure state Measure mentioned, doctors giving patients poison and correctly predicting outcomes, is just as likely as for the current clinical trial scheme.