Does random treatment assignment cause harm to research participants?

Some argue that by precluding individualized treatment, randomized clinical trials (RCTs) provide substandard medical care, while others claim that participation in clinical research is associated with improved patient outcomes. However, there are few data to assess the impact of random treatment as...

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Main Authors: Cary P Gross, Harlan M Krumholz, Gretchen Van Wye, Ezekiel J Emanuel, David Wendler
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2006-06-01
Series:PLoS Medicine
Online Access:http://europepmc.org/articles/PMC1470665?pdf=render
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author Cary P Gross
Harlan M Krumholz
Gretchen Van Wye
Ezekiel J Emanuel
David Wendler
author_facet Cary P Gross
Harlan M Krumholz
Gretchen Van Wye
Ezekiel J Emanuel
David Wendler
author_sort Cary P Gross
collection DOAJ
description Some argue that by precluding individualized treatment, randomized clinical trials (RCTs) provide substandard medical care, while others claim that participation in clinical research is associated with improved patient outcomes. However, there are few data to assess the impact of random treatment assignment on RCT participants. We therefore performed a systematic review to quantify the differences in health outcomes between randomized trial participants and eligible non-participants.Studies were identified by searching Medline, the Web of Science citation database, and manuscript references. Studies were eligible if they documented baseline characteristics and clinical outcomes of RCT participants and eligible non-participants, and allowed non-participants access to the same interventions available to trial participants. Primary study outcomes according to patient group (randomized trial participants versus eligible non-participants) were extracted from all eligible manuscripts. For 22 of the 25 studies (88%) meeting eligibility criteria, there were no significant differences in clinical outcomes between patients who received random assignment of treatment (RCT participants) and those who received individualized treatment assignment (eligible non-participants). In addition, there was no relation between random treatment assignment and clinical outcome in 15 of the 17 studies (88%) in which randomized and nonrandomized patients had similar health status at baseline.These findings suggest that randomized treatment assignment as part of a clinical trial does not harm research participants.
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spelling doaj.art-d3e2ad36b72f41d3bdfe05301c5247812022-12-22T02:05:19ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762006-06-0136e18810.1371/journal.pmed.0030188Does random treatment assignment cause harm to research participants?Cary P GrossHarlan M KrumholzGretchen Van WyeEzekiel J EmanuelDavid WendlerSome argue that by precluding individualized treatment, randomized clinical trials (RCTs) provide substandard medical care, while others claim that participation in clinical research is associated with improved patient outcomes. However, there are few data to assess the impact of random treatment assignment on RCT participants. We therefore performed a systematic review to quantify the differences in health outcomes between randomized trial participants and eligible non-participants.Studies were identified by searching Medline, the Web of Science citation database, and manuscript references. Studies were eligible if they documented baseline characteristics and clinical outcomes of RCT participants and eligible non-participants, and allowed non-participants access to the same interventions available to trial participants. Primary study outcomes according to patient group (randomized trial participants versus eligible non-participants) were extracted from all eligible manuscripts. For 22 of the 25 studies (88%) meeting eligibility criteria, there were no significant differences in clinical outcomes between patients who received random assignment of treatment (RCT participants) and those who received individualized treatment assignment (eligible non-participants). In addition, there was no relation between random treatment assignment and clinical outcome in 15 of the 17 studies (88%) in which randomized and nonrandomized patients had similar health status at baseline.These findings suggest that randomized treatment assignment as part of a clinical trial does not harm research participants.http://europepmc.org/articles/PMC1470665?pdf=render
spellingShingle Cary P Gross
Harlan M Krumholz
Gretchen Van Wye
Ezekiel J Emanuel
David Wendler
Does random treatment assignment cause harm to research participants?
PLoS Medicine
title Does random treatment assignment cause harm to research participants?
title_full Does random treatment assignment cause harm to research participants?
title_fullStr Does random treatment assignment cause harm to research participants?
title_full_unstemmed Does random treatment assignment cause harm to research participants?
title_short Does random treatment assignment cause harm to research participants?
title_sort does random treatment assignment cause harm to research participants
url http://europepmc.org/articles/PMC1470665?pdf=render
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