Comparing Drug Effectiveness at Health Plans: The Ethics of Cluster Randomized Trials
Sabin, James E.
Goff, Sarah L.
Hastings Center Report 2008 September-October; 38(5): 39-48
"Cluster randomized trials," in which groups of patients are randomly assigned to different therapeutic interventions, provide a powerful way of evaluating drugs. CRTs have not been widely used, in good part because of concerns about whether patients must give informed consent to participate in them. A better understanding of how CRTs fit into clinical practice resolves the concerns.
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Povar, Gail J.; Blumen, Helen; Daniel, John; Daub, Suzanne; Evans, Lois; Holm, Richard P.; Levkovich, Natalie; McCarter, Alice O.; Sabin, James; Snyder, Lois; Sulmasy, Daniel; Vaughan, Peter; Wellikson, Laurence D.; Campbell, Amy (2004-07-20)Cost pressures and changes in the health care environment pose ethical challenges and hard choices for patients, physicians, policymakers, and society. In 2000 and 2001, the American College of Physicians, with the Harvard ...
Edwards, Sarah J.L.; Braunholtz, David A.; Lilford, Richard J.; Stevens, Andrew J. (1999-05-22)In most randomised controlled trials, individual patients are randomised to a treatment or control group, but sometimes this is undesirable or even impossible and groups (clusters) of people may be randomised instead. These ...