Stats
Category: Equipoise in research. In a study where you randomly assign
patients to two or more different treatments, you need to provide assurance
that none of the patients is being harmed by having a chance at receiving an
inferior therapy. This assurance has several different definitions coming from
several different research perspectives, but a commonly used term is
"equipoise". These pages discuss some of the ethical and practical issues
associated with equipoise as well as debate over the proper interpretation of
this and other closely related terms. Articles are arranged by date with
the most recent entries at the top. You can find the
theme and closely related categories
and other resources at
the bottom of this page.
Stats: Two articles debating
equipoise (September 9, 2005). A frequent contributor to the IRBForum
(HM) mentioned a couple of articles that discuss equipoise and which are well
worth discussing in detail.
Stats: More thoughts on equipoise
(January 17, 2005). Vital to the ethical conduct of a clinical trial is
the concept of equipoise, that a researcher is clinically indifferent or
genuinely uncertain, as to whether a new therapy is better than the standard
therapy.
Stats: The ethics of
randomization (January 14, 2005). A recently published article,
Treatment at random: the ultimate science or the betrayal of Hippocrates?
Retsas S. J Clin Oncol 2004: 22(24); 5005-8; discussion 5009-11, attacks the
randomized trial and declares it to be "a deficient research tool both on
deontologic and methodologic grounds."
Stats: Alternatives to
equipoise (November 24, 2004). Stephen Senn wrote an interesting article
a couple of years ago that provides an intriguing alternative to the concept
of equipoise. I wrote about equipoise in a web page discussing the ethics of
placebo controlled trials. The concept of equipoise actually extends well
beyond placebo controlled trials, but it is in those trials that the concept
is most easily understood.
Stats: Adaptive randomization (July
15, 2004). Someone on the IRBForum posed a theoretical question. Is
running a three arm study troublesome from an ethical viewpoint because the
probability that any subject in the trial receives the best possible
treatment decreases from 50% to 33%?
Theme and closely related categories:
Other resources:
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This webpage was written on 2007-06-19 and was last modified on
2008-07-08.
