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

Liaw, Andy andy_liaw at merck.com
Tue Sep 21 13:52:14 CEST 2010


> From: JLucke at ria.buffalo.edu
> 
> Clearly inferior treatments are unethical. 

The Big Question is:  What constitute "clearly"?  Who or How to decide
what is "clearly"?  I'm sure there are plenty of people who don't
understand much Statistics and are perfectly willing to say the results
on the two cousins show the conventional treatment is "clearly
inferior".  Sure, on these two cousins we can say so, but what about
others?
 
> 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.
 
I've heard LJ Wei talked about this kinds of designs (don't remember if
they are Bayesian) more than a dozen years ago.  Don't know how common
they are in use. 

Andy 

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