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International Journal of Epidemiology, Volume 33, Number 2, pp. 247-251
IJE vol.33 no.2 © International Epidemiological Association 2004; all rights reserved.

Commentary

Commentary: Unbiased divination, unbiased evidence, and the patulin clinical trial

Ted J Kaptchuk1 and Catherine E Kerr2

1 Osher Institute, and 2 Department of Social Medicine, Harvard Medical School, 401 Park Drive, Landmark Building, Boston, MA 02215, USA

Correspondence: Ted J Kaptchuk, Osher Institute, Harvard Medical School, 401 Park Drive, Landmark Building, Boston, MA 02215, USA. E-mail: Ted_Kaptchuk{at}hms.harvard.edu

The first 150 words of the full text of this article appear below.

Histories of the randomized clinical trial (RCT) are constantly unearthing dramatic precursors for concurrent controls, random assignment to comparison group, blind assessment, placebo controls, and statistical inference.1–4 All these forerunners seem to indicate a constantly budding but, somehow, stumbling and aborted development toward the modern methodology. While most of the methods (at least in primitive forms) seem known in numerous early sources, it is not clear why medicine as a profession refused to commit itself to safeguards against bias until after World War II. The 60th anniversary of the under-appreciated and critical placebo controlled clinical trial of patulin for the common cold is a timely moment to offer some historical reflections on the origin and final acceptance of the RCT.

This commentary will hypothesize that the modern methods to reduce bias in clinical research—especially randomization, concurrent controls, and blinding—in at least rudimentary forms—were well known to educated physicians and, in . . . [Full Text of this Article]


   Unbiased divination
 

   Unbiased experimentation
 

   The patulin trial
 

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