R help - Sep 2010 - OT: Is randomization for targeted cancer therapies ethical?

Hi Folks:

**Off Topic**

Those interested in clinical trials may find the following of interest:

http://www.nytimes.com/2010/09/19/health/research/19trial.html

It concerns the ethicality of randomizing those with life-threatening
disease to relatively ineffective SOC when new "biologically targeted"
therapies "appear" to be more effective. While the context may be new,
the debate, itself, is not: Tukey wrote (or maybe it was talked -- I
can't remember for sure) about this about 30 years ago. I'm sure many
other also have done so.

Cheers,

Bert
-- 
Bert Gunter
Genentech Nonclinical Biostatistics

On Mon, 20 Sep 2010, Bert Gunter wrote:
> Hi Folks:
>
> **Off Topic**
>
> Those interested in clinical trials may find the following of interest:
>
> http://www.nytimes.com/2010/09/19/health/research/19trial.html
>
> It concerns the ethicality of randomizing those with life-threatening
> disease to relatively ineffective SOC when new "biologically
targeted"
> therapies "appear" to be more effective. While the context may be
new,
> the debate, itself, is not: Tukey wrote (or maybe it was talked -- I
> can't remember for sure) about this about 30 years ago. I'm sure
many
> other also have done so.
Anscombe's remarkable (and influential) review of Armitage's
'Sequential
Medical Trials' back in 1963

 	http://www.jstor.org/stable/2283272

is worth a look by any statistician who is interested in this topic.

It makes explicit several factors that weigh in the ethical assessment of 
a particular trial design.

He discusses in formal terms the weighing of outcomes for patients 
in the trial at hand aginst those of future patients and the impact that 
this might have on design decisions.

HTH,

Chuck

>
> Cheers,
>
> Bert
> -- 
> Bert Gunter
> Genentech Nonclinical Biostatistics
>
> ______________________________________________
> R-help at r-project.org mailing list
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> PLEASE do read the posting guide
http://www.R-project.org/posting-guide.html
> and provide commented, minimal, self-contained, reproducible code.
>
Charles C. Berry                            (858) 534-2098
                                             Dept of Family/Preventive Medicine
E mailto:cberry at tajo.ucsd.edu	            UC San Diego
http://famprevmed.ucsd.edu/faculty/cberry/  La Jolla, San Diego 92093-0901

Clearly inferior treatments are unethical. 

Donald Berry at MD Anderson in Houston TX  and Jay Kadane at Carnegie 
Mellon have been working on more ethical designs within the Bayesian 
framework.  In particular, response adaptive designs reduce the assignment 
to and continuation of patients on inferior treatments.






Bert Gunter <gunter.berton@gene.com> 
Sent by: r-help-bounces@r-project.org
09/20/2010 01:31 PM

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[R] OT: Is randomization for targeted cancer therapies ethical?






Hi Folks:

**Off Topic**

Those interested in clinical trials may find the following of interest:

http://www.nytimes.com/2010/09/19/health/research/19trial.html

It concerns the ethicality of randomizing those with life-threatening
disease to relatively ineffective SOC when new "biologically targeted"
therapies "appear" to be more effective. While the context may be new,
the debate, itself, is not: Tukey wrote (or maybe it was talked -- I
can't remember for sure) about this about 30 years ago. I'm sure many
other also have done so.

Cheers,

Bert
-- 
Bert Gunter
Genentech Nonclinical Biostatistics

______________________________________________
R-help@r-project.org mailing list
https://stat.ethz.ch/mailman/listinfo/r-help
PLEASE do read the posting guide 
http://www.R-project.org/posting-guide.html
and provide commented, minimal, self-contained, reproducible code.


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