Talk:2530: Clinical Trials - Revision history

172.70.90.29 at 19:41, 26 March 2024

2024-03-26T19:41:17Z

172.70.160.166 at 19:37, 26 March 2024

2024-03-26T19:37:45Z

Whoop whoop pull up at 17:58, 26 March 2024

2024-03-26T17:58:17Z

256 256.256.256 at 14:44, 16 December 2021

2021-12-16T14:44:01Z

256 256.256.256 at 07:41, 6 December 2021

2021-12-06T07:41:27Z

108.162.237.243 at 00:44, 5 November 2021

2021-11-05T00:44:21Z

108.162.237.243 at 00:42, 5 November 2021

2021-11-05T00:42:57Z

Mneme: removed incorrect/accidental attribution

2021-10-26T11:57:58Z

removed incorrect/accidental attribution

Mneme: pullec

2021-10-26T11:56:31Z

pullec

172.68.132.16 at 19:18, 22 October 2021

2021-10-22T19:18:14Z

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 :CTs cover "investigational" (just look how people are doing/have done under whatever course of treatment they might have, with no actual provision of anything new) and "interventional" (as above). A good study design will have a way to check the ongoing treatment (still blind/anonymised) and, if it warrants it (and it's not a review of historic data!), breaking the double-blind early and offering all subcohorts any treatment (or 'default') that has outperformed the other(s) being given. Useful both if the investigated drug is shown to be a 'miracle cure' ''or'' if it's a flop/worse than the old drug/has too many additional adverse events to be considered safe.
 :A modern trial (well... a decade ago, when I was work-adjacent to such trials, so picked up a lot from my colleagues who actually did trial design and management) probably covers all the points you suggest, all still under the same umbrella of "Clinical Trial". The exact specifics of how they proceded would depend a lot on what the trial was for, etc, and by the time Phase III (full clinical trials) were being started, the results of the Phase I/II (first-in-human/sub-theraputic tests) would have been concluded or wound up early (with sufficient success), giving a good idea of how much 'denied treatment' (or "given the prior treatment") is absolutely required, without being potentially excessive in caution.
-:And pretty much every one is bespoke. Trials of off-label uses, extending trials of adult-approved drugs to adolescents/children, or allowing their previously barred use in pregnant women. Restudying a drug that hadn't been tested ''at all'' in women (allowing for pesky hormone cycles, perhaps, which the men-only test had avoided). Intensively studying something truly life-saving (resuscitation methods, anti-AIDS treatments, pandemic vaccines) or quality-of-life extending (anti-dementia, treatments for Parkinsons, less traumatic chemotherapy). - Some, if not all, will consider how quickly the generously volunteering (or 'volunteered' control group might still be able to benefit from their being not-fully-treated (where possible, practical and proven as advantageous).
+:And pretty much every one is bespoke. Trials of off-label uses, extending trials of adult-approved drugs to adolescents/children, or allowing their previously barred use in pregnant women. Restudying a drug that hadn't been tested ''at all'' in women (allowing for pesky hormone cycles, perhaps, which the men-only test had avoided). Intensively studying something truly life-saving (resuscitation methods, anti-AIDS treatments, pandemic vaccines) or quality-of-life extending (anti-dementia, treatments for Parkinsons, less traumatic chemotherapy). - Some, if not all, will consider how quickly the generously volunteering (or 'volunteered') control group might still be able to benefit from their originally being not-fully-treated (where possible, practical and proven as advantageous).
-:But it's not something I was ditectly involved in, my responsibilities were in making sure that those with the more direct responsibilities could do their work properly, however it was they needed to in any given instance. I think I'd have been more stressed designing and managing a trial than I was (technically could affect ''numerous'' trials, or at least potentially increasing everyone else's stress values if I totally messed). I'm sure there's a more accurate/succinct explanation available. [[Special:Contributions/172.70.160.166|172.70.160.166]] 19:37, 26 March 2024 (UTC)
+:But it's not something I was directly involved in, my responsibilities were in making sure that those with the more direct responsibilities could do their work properly, however it was they needed to in any given instance. I think I'd have been more stressed designing and managing a trial than I was (technically could affect ''numerous'' trials, or at least potentially increasing everyone else's stress values if I totally messed). I'm sure there's a more accurate/succinct explanation available. [[Special:Contributions/172.70.160.166|172.70.160.166]] 19:37, 26 March 2024 (UTC)

← Older revision		Revision as of 19:37, 26 March 2024
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	Traditional clinical trials aren't the ''only'' way to find out whether a particular medical treatment works; a lot of treatments used for various purposes instead get tested and adopted by comparing the outcomes of the treated group to prior outcomes of people with the same condition, or simply comparing whether the healths of a group of people improve after treatment with a given treatment with a ''known'' mechanism of action (thus circumventing the correlation/causation disconnect); for ethical reasons, not everything ''can'' be put through traditional clinical trials (as it would be unethical to deny a patient [even one who's part of a control group] treatment that's been shown to have lifesaving effects in other patients), and is thus used technically-off-label based on these secondary ways of showing efficacy (for instance, gender-affirming hormonal and surgical treatment for transgender individuals). [[User:Whoop whoop pull up\|Whoop whoop pull up]] ([[User talk:Whoop whoop pull up\|talk]]) 17:58, 26 March 2024 (UTC)		Traditional clinical trials aren't the ''only'' way to find out whether a particular medical treatment works; a lot of treatments used for various purposes instead get tested and adopted by comparing the outcomes of the treated group to prior outcomes of people with the same condition, or simply comparing whether the healths of a group of people improve after treatment with a given treatment with a ''known'' mechanism of action (thus circumventing the correlation/causation disconnect); for ethical reasons, not everything ''can'' be put through traditional clinical trials (as it would be unethical to deny a patient [even one who's part of a control group] treatment that's been shown to have lifesaving effects in other patients), and is thus used technically-off-label based on these secondary ways of showing efficacy (for instance, gender-affirming hormonal and surgical treatment for transgender individuals). [[User:Whoop whoop pull up\|Whoop whoop pull up]] ([[User talk:Whoop whoop pull up\|talk]]) 17:58, 26 March 2024 (UTC)
		+	:I'd argue that "traditional clinical trials" were pretty much all "we gave our tincture to everyone, and they almost all survived". It's the lack of rigour that introduced various additional elements, like the double-blind New Treatment vs. Old Treatment, or Treatment vs. Placebo, 'golden standard'.
		+	:CTs cover "investigational" (just look how people are doing/have done under whatever course of treatment they might have, with no actual provision of anything new) and "interventional" (as above). A good study design will have a way to check the ongoing treatment (still blind/anonymised) and, if it warrants it (and it's not a review of historic data!), breaking the double-blind early and offering all subcohorts any treatment (or 'default') that has outperformed the other(s) being given. Useful both if the investigated drug is shown to be a 'miracle cure' ''or'' if it's a flop/worse than the old drug/has too many additional adverse events to be considered safe.
		+	:A modern trial (well... a decade ago, when I was work-adjacent to such trials, so picked up a lot from my colleagues who actually did trial design and management) probably covers all the points you suggest, all still under the same umbrella of "Clinical Trial". The exact specifics of how they proceded would depend a lot on what the trial was for, etc, and by the time Phase III (full clinical trials) were being started, the results of the Phase I/II (first-in-human/sub-theraputic tests) would have been concluded or wound up early (with sufficient success), giving a good idea of how much 'denied treatment' (or "given the prior treatment") is absolutely required, without being potentially excessive in caution.
		+	:And pretty much every one is bespoke. Trials of off-label uses, extending trials of adult-approved drugs to adolescents/children, or allowing their previously barred use in pregnant women. Restudying a drug that hadn't been tested ''at all'' in women (allowing for pesky hormone cycles, perhaps, which the men-only test had avoided). Intensively studying something truly life-saving (resuscitation methods, anti-AIDS treatments, pandemic vaccines) or quality-of-life extending (anti-dementia, treatments for Parkinsons, less traumatic chemotherapy). - Some, if not all, will consider how quickly the generously volunteering (or 'volunteered' control group might still be able to benefit from their being not-fully-treated (where possible, practical and proven as advantageous).
		+	:But it's not something I was ditectly involved in, my responsibilities were in making sure that those with the more direct responsibilities could do their work properly, however it was they needed to in any given instance. I think I'd have been more stressed designing and managing a trial than I was (technically could affect ''numerous'' trials, or at least potentially increasing everyone else's stress values if I totally messed). I'm sure there's a more accurate/succinct explanation available. [[Special:Contributions/172.70.160.166\|172.70.160.166]] 19:37, 26 March 2024 (UTC)

← Older revision		Revision as of 17:58, 26 March 2024
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	The Covid-19 paragraph seems a bit misleading. Arguments advanced in favour of vaccine skepticism have mostly been not so much to do with treatments being used before clinical trials were complete, as with clinical trials being brought forward to accelerate the process, which has been misinterpreted as them being 'rushed'. [[Special:Contributions/162.158.154.206\|162.158.154.206]] 10:38, 20 October 2021 (UTC)		The Covid-19 paragraph seems a bit misleading. Arguments advanced in favour of vaccine skepticism have mostly been not so much to do with treatments being used before clinical trials were complete, as with clinical trials being brought forward to accelerate the process, which has been misinterpreted as them being 'rushed'. [[Special:Contributions/162.158.154.206\|162.158.154.206]] 10:38, 20 October 2021 (UTC)
		+
		+	Traditional clinical trials aren't the ''only'' way to find out whether a particular medical treatment works; a lot of treatments used for various purposes instead get tested and adopted by comparing the outcomes of the treated group to prior outcomes of people with the same condition, or simply comparing whether the healths of a group of people improve after treatment with a given treatment with a ''known'' mechanism of action (thus circumventing the correlation/causation disconnect); for ethical reasons, not everything ''can'' be put through traditional clinical trials (as it would be unethical to deny a patient [even one who's part of a control group] treatment that's been shown to have lifesaving effects in other patients), and is thus used technically-off-label based on these secondary ways of showing efficacy (for instance, gender-affirming hormonal and surgical treatment for transgender individuals). [[User:Whoop whoop pull up\|Whoop whoop pull up]] ([[User talk:Whoop whoop pull up\|talk]]) 17:58, 26 March 2024 (UTC)

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 ::Except the vaccines HAVE gone through clinical trials? Calling the vaccines "untested" is quite a reach, since they have actually been very well tested. [[Special:Contributions/172.68.132.228|172.68.132.228]] 18:56, 22 October 2021 (UTC)
 ::: They may have been through smaller, short-term trials, but we don't have any long-term effects data. Essentially, everyone who has gotten a shot is in one big trial.--[[Special:Contributions/108.162.237.243|108.162.237.243]] 00:44, 5 November 2021 (UTC)
-::::Yeah, a trial consisting of 3.3 billion fully vaccinated people. If it was any worse than being unvaccinated, wouldn't we have noticed by now? [[User:256 256.256.256|256.256.256.256]] ([[User talk:256 256.256.256|talk]]) 07:41, 6 December 2021 (UTC)
+::::Yeah, a trial consisting of 3.3 billion fully vaccinated people. If it was any worse than being unvaccinated, wouldn't we have noticed by now? [[User:256.256.256.256|256.256.256.256]] ([[User talk:256.256.256.256|talk]]) 07:41, 6 December 2021 (UTC)
 I would say this in relation to the mutiple treatments for Covid19 some of which have great clinical evaluation, others less so.  I'll make a first draft [[User:Kev|Kev]] ([[User talk:Kev|talk]]) 21:53, 18 October 2021 (UTC)

@@ Line 5: / Line 5: @@
 ::Except the vaccines HAVE gone through clinical trials? Calling the vaccines "untested" is quite a reach, since they have actually been very well tested. [[Special:Contributions/172.68.132.228|172.68.132.228]] 18:56, 22 October 2021 (UTC)
 ::: They may have been through smaller, short-term trials, but we don't have any long-term effects data. Essentially, everyone who has gotten a shot is in one big trial.--[[Special:Contributions/108.162.237.243|108.162.237.243]] 00:44, 5 November 2021 (UTC)
 I would say this in relation to the mutiple treatments for Covid19 some of which have great clinical evaluation, others less so.  I'll make a first draft [[User:Kev|Kev]] ([[User talk:Kev|talk]]) 21:53, 18 October 2021 (UTC)

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 :I'm of the opinion that it was part of the joke... since it does seem to follow the actual behavioral pattern of "do thing, promote thing, [justify thing], propagate thing"... which makes this thread of conversation both topical and meta (kudos to Randall if ''this'' result was intended)[[Special:Contributions/162.158.107.4|162.158.107.4]] 21:14, 19 October 2021 (UTC)
 : I'm guessing you've never written a grant proposal. To get money to test something, you have to convince people it's worth testing. [[Special:Contributions/172.68.133.103|172.68.133.103]] 19:01, 22 October 2021 (UTC)
-Mention of "anti-worming treatments" in the explanation.  This is misleading, and gives the impression that drugs can only have a single function.  It's like talking about the use of "headache medicine" for preventing heart attacks.  If you want to refer to a specific medicine, do so by name but make damn sure that your claims about that medicine are accurate [[User:Mneme|Mneme]] ([[User talk:Mneme|talk]]) 04:36, 19 October 2021 (UTC)
+Mention of "anti-worming treatments" in the explanation.  This is misleading, and gives the impression that drugs can only have a single function.  It's like talking about the use of "headache medicine" for preventing heart attacks.  If you want to refer to a specific medicine, do so by name but make damn sure that your claims about that medicine are accurate
 :Ivermectin, the drug in question, has only been approved for use by humans for parasites, and for rosacea (cause unknown, but appears to be linked to mites). It doesn't seem misleading to me to refer to it as a deworming agent when it is probably only ever prescribed as an anti-parasitic. [[Special:Contributions/172.68.132.16|172.68.132.16]] 19:18, 22 October 2021 (UTC)

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 Shouldn't Test if it works be step 2?  Have idea, see if it works, impliment?  [[Special:Contributions/172.68.129.137|172.68.129.137]] 01:52, 19 October 2021 (UTC)
-:No.  Steps 1 and 2 both include elements of testing and exploration; you need to perform experiments to come up with a good idea and convince -yourselves- that it is, in fact, good, and then you likely need to perform or at least show more tests to convince others that it is, in fact a good idea.  But the addition of clinical trials added a further "and then you need to double triple check that your idea actually works rather than that it seemed to work in your initial experiments" step to (try to) avoid bad side effects and false correlation. [[User:Mneme|Mneme]] ([[User talk:Mneme|talk]]) 02:40, 19 October 2021 (UTC)
+:No.  Steps 1 and 2 both include elements of testing and exploration; you need to perform experiments to come up with a good idea and convince -yourselves- that it is, in fact, good, and then you likely need to perform or at least show more tests to convince others that it is, in fact a good idea.  But the addition of clinical trials added a further "and then you need to double triple check that your idea actually works rather than that it seemed to work in your initial experiments" step to (try to) avoid bad side effects and false correlation.
 :I'm of the opinion that it was part of the joke... since it does seem to follow the actual behavioral pattern of "do thing, promote thing, [justify thing], propagate thing"... which makes this thread of conversation both topical and meta (kudos to Randall if ''this'' result was intended)[[Special:Contributions/162.158.107.4|162.158.107.4]] 21:14, 19 October 2021 (UTC)
 : I'm guessing you've never written a grant proposal. To get money to test something, you have to convince people it's worth testing. [[Special:Contributions/172.68.133.103|172.68.133.103]] 19:01, 22 October 2021 (UTC)