Most medical trials may be unethical, suggests Canadian paper
A paper by Canadian scientists on the Journal of Clinical Epidemiology may confirm the hypothesis that most clinical trials (medical experimentation on humans) may be scientifically, and therefore ethically unjustified.
The article, published on January 3, 2018, explains that the majority of articles analysed (all RCTs published in the New England Journal of Medicine and the Journal of the American Medical Association) do not meet the criteria to be considered scientifically justified.
According to the article's highlights, " For RCTs (randomized clinical trials) to be ethically justified, they must be scientifically justified. How RCTs should be scientifically justified is unclear". They also proposed 3 criteria to determine if a RCT is scientifically justified:
(1) they should be designed around a clear hypothesis (they should try to answer a specific question);
(2) uncertainty should exist around that hypothesis (the answer to the question must be unknown);
(3) that uncertainty should be as established through a systematic review of available knowledge (the experimenters must make sure the answer is truly unknown by studying previous work)
According to the paper's results: "Among combined articles and protocols, 76% had a clearly stated hypothesis, 99% referenced some form of uncertainty, and 54% cited a relevant systematic review or meta-analysis. Only 44% of combined texts contained all three scientific criteria."
Finally, the authors recommend: "RCTs should be required to have a clear hypothesis and to document the presence of uncertainty around the research question through a systematic review or meta-analysis".
