Derek Lowe is always the high-quality skeptic on all things pharma, and that’s a valuable role. Still, I feel like this isn’t really engaging with the issues:https://blogs.sciencemag.org/pipeline/archives/2020/05/01/why-are-clinical-trials-so-complicated …
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The *empirical* hypothesis I’m making, which I *do* expect to be a question even skeptics should care about investigating, is that the “optimal” minimum standard for clinical trials is looser than the present standard.
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In other words, if there were a proliferation of sloppier trials, would the benefit of getting true positives sooner (& thus faster, cheaper drugs) outweigh the harms of people getting sick from ineffective or dangerous drugs that were reported as good?
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I could imagine a world where lower-quality trials were so useless that nobody intelligent believed them. In that case, legalizing them would be morally correct according to me, but a loss from a societal benefit perspective.
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Fortunately we have a great natural experiment right now! COVID19 drug & vaccine development is moving at much faster than usual speeds and skipping a lot of typical precautionary steps.
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If this “works” for generating drugs or vaccines that actually work, faster or cheaper than average, then we’ll know that there can be value in streamlining these processes.
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Thanks for giving
@Dereklowe a deserved signal boost. My thoughts have gone in a similar direction as yours, but with a bit of collectivism on responsibility for making information available for deciding what is crap. -
Conditional on many people being unable or unwilling to decide for themselves (maybe they'd rather spend their time thinking about other stuff!), my ethical position is that it's not right to leave a guidance vacuum, because there's any number of hucksters that will fill it.
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This is the same kind of argument people use to say seatbelt laws are bad. However, the gen pop is many orders of magnitude less equipped to decide what is crap and what isn't in clinical studies than searbelts. It's absolutely unethical to let people make that decision
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Mainly because snake oil salesmen will 100 % abuse that decision. We already see that with people like "Drs" Oz and Phil.
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Yes, but are "we" all capable to take these decisions ? By that, I mean do we, like common people, have the knowledge to distinguish "good" from "crap" medecines in this very case ?
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Not everyone has to know about medicine themselves; they just have to decide which sources they trust.
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