Apologies to Epidemio-l subscribers who have already seen this. But it raised no reponse there.
In BMJ 1998;317:1170 (31 October) Richard Peto writes that using "the uncertainty principle" simplifies entry criteria in randomised trials.
Explained as: "A patient can be entered if, and only if, the responsible clinician is substantially uncertain which of the trial treatments would be most appropriate for that particular patient. A patient should not be entered if the responsible clinician or the patient are for any medical or non-medical reasons reasonably certain that one of the treatments that might be allocated would be inappropriate for this particular individual (in comparison with either no treatment or some other treatment that could be offered to the patient in or outside of the trial)."
I understand the ethical importance, but would like to understand how it simplifies things? Seems to me that it does not replace having entry criteria, and it complicates the responsibility of the clinicians whose recruitment to participating in trials Peto hopes to increase?
Thanks for explanations,
Ronald
Dr Ronald Ingle
Senior Lecturer, Family Medicine
Medical University of Southern Africa
Pretoria
0204 South Africa
Email [log in to unmask]
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