A good thread, but I have one quibble. A new bracing for the same disease doesn’t necessarily have to be better than current standard of care. It has to be not detectably inferior; i.e., at least as good as the existing standard of care. https://twitter.com/AlastairMcA30/status/1194169380193439744 …
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After all, a vaccine or drug that’s as effective as the old drug or vaccine could be desirable for a number of reasons. It could be cheaper. It could be more stable in storage. It could have a side effect profile that would make it better for a subgroup of patients.
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That quibble aside, the rest of the thread is correct. If there’s an existing standard-of-care vaccine for a given disease, it’s unethical to do a randomized, placebo-controlled trial for a new vaccine against that same disease. You have to compare the new vaccine to the old.
9:30 AM - 12 Nov 2019
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