7 ms·

I would argue that as a terminal patient, I certainly would not want to be part of the control group taking a placebo or no treatment at all, and that the scien

I would argue that as a terminal patient, I certainly would not want to be part of the control group taking a placebo or no treatment at all, and that the scientific method could still be applied later when you still have a lot of people that took the treatment compared to a lot of people who didn't, for one reason or another. I imagine scientific grants could be funded on an individual basis, if the individual is rich enough.

ekianjo 12y ago
Usualy placebo arms get less than 50% of the patients anyway. So most people on trials get the drug. And no, you cannot "apply the science later" because you specifically want to see the difference in PFS (progression free survival) and OS (overall survival) on both groups, and for it to be comparable they need to start with the same baseline.
- phkahler 12y ago
  But we're talking about people who have been told "this disease is going to kill you." If a treatment causes even 5 percent of them to be cured, how is that not significant? What if 40 percent have tumors shrink? Remember, any reversal of the disease is a good thing. If you're just measuring a statistical increase in life span (say 3 years treated vs 1 year placebo), I'd say you're not really aiming high enough. If you've got something with real promise you'd know it without a control group. The person in this article is exactly such a case.
  - zacinbusiness 12y ago
    It's more that the controlled placebo group will also be controlled for other medications that could compromise the research. If I have cancer A and I'm taking three or four medications + an experimental medication then it's difficult to know which factor affects the results. So the control group will be on the same types of medication in a proper study where as a sort of ad-hoc grouping of patients would be less easy if not impossible to accurately report.
    - phkahler 12y ago
      I assumed we'd be comparing to the predicted outcome from no treatment, but I suppose if you wait until Hospice time there's not going to be much success with even the best virus compared to doing nothing. Which raises other questions about just how long and at what cost we try to delay the inevitable.
Fomite 12y ago
For many drug trials, the "control" group isn't getting no drugs - they're getting the current standard of care, whatever that is.

ekianjo 12y ago

Usualy placebo arms get less than 50% of the patients anyway. So most people on trials get the drug. And no, you cannot "apply the science later" because you specifically want to see the difference in PFS (progression free survival) and OS (overall survival) on both groups, and for it to be comparable they need to start with the same baseline.

phkahler 12y ago
But we're talking about people who have been told "this disease is going to kill you." If a treatment causes even 5 percent of them to be cured, how is that not significant? What if 40 percent have tumors shrink? Remember, any reversal of the disease is a good thing. If you're just measuring a statistical increase in life span (say 3 years treated vs 1 year placebo), I'd say you're not really aiming high enough. If you've got something with real promise you'd know it without a control group. The person in this article is exactly such a case.
- zacinbusiness 12y ago
  It's more that the controlled placebo group will also be controlled for other medications that could compromise the research. If I have cancer A and I'm taking three or four medications + an experimental medication then it's difficult to know which factor affects the results. So the control group will be on the same types of medication in a proper study where as a sort of ad-hoc grouping of patients would be less easy if not impossible to accurately report.
  - phkahler 12y ago
    I assumed we'd be comparing to the predicted outcome from no treatment, but I suppose if you wait until Hospice time there's not going to be much success with even the best virus compared to doing nothing. Which raises other questions about just how long and at what cost we try to delay the inevitable.

Fomite 12y ago

For many drug trials, the "control" group isn't getting no drugs - they're getting the current standard of care, whatever that is.