| The point is to discover real medicine that really cures the people. If there is no clinical trial, how are you so sure that this treatment is better than the previous one? You can trust the gut feeling of the experts, but that is not enough. The rules for a clinical trial are complex, but they are created to avoid some mistakes (or frauds) of the past. In particular of the recent changes is traying to force preregistration. https://en.wikipedia.org/wiki/Clinical_trials_registry Because it's too easy to massage the results after the trial to get a lot of results and then report only the "good" result and hide the others. The "good" result is an statistical fluke, so any attempt to reproduce the trial will fail. Another older requisite is having a control group with a double blind setup if possible. For example, they tried this drug in 31 people. Did this 31 people get better average results than the other patients with the old treatment? They are probably applying the experimental treatment only to people that is not near death. If someone is going to die in a month and is very weak, you don't want to kill him because the new treatment has an unexpected side effect, or get blamed that the treatment killed him instead of the previous condition, or that the family later says that he was too weak to give an informed consent, or get random problems because the organs are too broken, or ... So there are some explicit and implicit filtration rules. Does the patient has any additional illness? Is s/he to young or too old? When you take the average result of the patients in the study and the patients with the normal treatment, are you using the same explicit and implicit filtration rules. What about long term effects? What about the periodic medical checks during the trial that detect early signs of other problems? Does they eat more healthy food during the trial? So you need a control group chosen at random after you decide to include or exclude the patient in the study, so you try ensure that you have the same population. Preferably a double blind experiment because the patients may give inaccurate reports if they thing that the treatment is good, and the medics and nurses also are influenced by their expectations. And in these trials, the control don't get a placebo, but the usual treatment, because using a placebo when there is some good treatment is unethical. This is a rule, because some people try to do this anyway, because it's easier to show that the new treatment is better than the placebo than to show that it's better than the current treatment. Also, they have only 31 patients, that is barely usable to make statistics. The error bars for 31 subjects are huge (something like 5%). The difference must be huge to get a statistical significant result. You can trust the gut feeling of the experts to think new treatments, but they must prove that the treatment is effective. Otherwise, you can't distinguish between a expert with good ideas, a moron and someone who wants to sell you snake oil. |