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知情同意书在安慰剂对照试验中的应用:伦理学与科学是否存在冲突?

Informed Consent for Placebo-Controlled Trials: Do Ethics and Science Conflict?

机构信息

Research fellow in the Department of Thoracic and Cardiovascular Surgery at the University of Texas MD Anderson Cancer Center.

Senior investigator in the Department of Emergency Medicine at the Boston Medical Center at the Boston University School of Medicine.

出版信息

Ethics Hum Res. 2022 Sep;44(5):42-48. doi: 10.1002/eahr.500142.

Abstract

The use of a placebo has been considered the best method for controlling bias in a prospective randomized clinical trial and provides the most rigorous test of treatment efficacy for evaluating a medical therapy. Placebos commonly produce clinically important effects particularly in studies where the primary outcomes are subjective. Yet the potential beneficial or harmful effects of placebos are often not addressed in designing a clinical trial, calculating the sample size, seeking consent, or interpreting clinical trial results. In this manuscript, we use an actual study to indicate three approaches that might be considered in seeking informed consent for placebo-controlled trials, and we explore the fundamental ethical and scientific complexities involved with each.

摘要

安慰剂的使用被认为是控制前瞻性随机临床试验偏倚的最佳方法,为评估一种医学疗法的疗效提供了最严格的测试。安慰剂通常会产生重要的临床效果,特别是在主要结果是主观的研究中。然而,在设计临床试验、计算样本量、寻求同意或解释临床试验结果时,安慰剂的潜在有益或有害影响往往没有得到考虑。在本文中,我们使用一个实际的研究来表示在寻求安慰剂对照试验知情同意时可以考虑的三种方法,并探讨了每种方法所涉及的基本伦理和科学复杂性。

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