3 ms·

If we know the statistical evolution of a well known cancer, why not giving the treatment to everyone? If we know that cancer A ends deadly in an an average of

If we know the statistical evolution of a well known cancer, why not giving the treatment to everyone? If we know that cancer A ends deadly in an an average of 6 months for 90% of the population and if our treatment has wildly different results, why wonder?

londons_explore 4y ago
It's important to have a control group to prevent the placebo effect in both the patients and in clinicians. If a patient thinks they are on a treatment, they might actually end up healthier than a patient who has just been told there are no treatment options left for them... Likewise, if a clinician is really hoping the new drug they are developing is successful, their judgement of exactly how quickly a tumour is growing might not be fully impartial. However, there is no need for the control group and treatment group to be 50/50. The control group can also be shared with other studies - although that makes risk budget allocation complex, but not impossible.
- BrandoElFollito 4y ago
  > If a patient thinks they are on a treatment, they might actually end up healthier than a patient who has just been told there are no treatment options left for them... Isn't the actual aim? to have someone heal? > Likewise, if a clinician is really hoping the new drug they are developing is successful, their judgement of exactly how quickly a tumour is growing might not be fully impartial Well, this is something that is quantifiable I guess (a measurement). And changes must be notable in order to call something a success in that case.
- carlineng 4y ago
  Clinical trials for cancer treatment rarely use placebos. Instead, the control group is the current standard of care: https://www.cancer.net/research-and-advocacy/clinical-trials/placebos-cancer-clinical-trials https://www.cancer.net/research-and-advocacy/clinical-trials...
evandijk70 4y ago
Some reasons to include a control group - Trials tend to be conducted at the best facilities, and they monitor their patients extremely well. Thus, control groups in a trial tend to have a better outcome than the general population. - Patients included in trials tend to be better informed and better motivated to seek treatment. - When trials are run in a specific location, the patient group may be different than the general population (younger/older, less/more exposure to carcinogens, etc.). Note that all of these are in favor of approval for the experimental drug, and combined with financial interest/pressure from pharmaceutical companies to get approval of a drug, leaving out a control group is a recipe for disaster. The hypothetical case you describe where a cancer ends deadly in an average of 6 months for 90% of the population and is suddenly cured by a miracle treatment simply does not happen (see https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival/all-cancers-combined#heading-One https://www.cancerresearchuk.org/health-professional/cancer-... for some statistics), so you will always need a control group.
- BrandoElFollito 4y ago
  > The hypothetical case you describe where a cancer ends deadly in an average of 6 months for 90% of the population and is suddenly cured by a miracle treatment simply does not happen That was an exaggeration (in line with the title of the article) - what I meant are cases where we historically have a good knowledge of the trajectory of an illness and this could be used as the control group.

londons_explore 4y ago

It's important to have a control group to prevent the placebo effect in both the patients and in clinicians. If a patient thinks they are on a treatment, they might actually end up healthier than a patient who has just been told there are no treatment options left for them... Likewise, if a clinician is really hoping the new drug they are developing is successful, their judgement of exactly how quickly a tumour is growing might not be fully impartial. However, there is no need for the control group and treatment group to be 50/50. The control group can also be shared with other studies - although that makes risk budget allocation complex, but not impossible.

BrandoElFollito 4y ago
> If a patient thinks they are on a treatment, they might actually end up healthier than a patient who has just been told there are no treatment options left for them... Isn't the actual aim? to have someone heal? > Likewise, if a clinician is really hoping the new drug they are developing is successful, their judgement of exactly how quickly a tumour is growing might not be fully impartial Well, this is something that is quantifiable I guess (a measurement). And changes must be notable in order to call something a success in that case.
carlineng 4y ago
Clinical trials for cancer treatment rarely use placebos. Instead, the control group is the current standard of care: https://www.cancer.net/research-and-advocacy/clinical-trials/placebos-cancer-clinical-trials https://www.cancer.net/research-and-advocacy/clinical-trials...

evandijk70 4y ago

Some reasons to include a control group - Trials tend to be conducted at the best facilities, and they monitor their patients extremely well. Thus, control groups in a trial tend to have a better outcome than the general population. - Patients included in trials tend to be better informed and better motivated to seek treatment. - When trials are run in a specific location, the patient group may be different than the general population (younger/older, less/more exposure to carcinogens, etc.). Note that all of these are in favor of approval for the experimental drug, and combined with financial interest/pressure from pharmaceutical companies to get approval of a drug, leaving out a control group is a recipe for disaster. The hypothetical case you describe where a cancer ends deadly in an average of 6 months for 90% of the population and is suddenly cured by a miracle treatment simply does not happen (see https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival/all-cancers-combined#heading-One https://www.cancerresearchuk.org/health-professional/cancer-... for some statistics), so you will always need a control group.

BrandoElFollito 4y ago
> The hypothetical case you describe where a cancer ends deadly in an average of 6 months for 90% of the population and is suddenly cured by a miracle treatment simply does not happen That was an exaggeration (in line with the title of the article) - what I meant are cases where we historically have a good knowledge of the trajectory of an illness and this could be used as the control group.