Friday, August 19, 2011

Statistician Meier saved millions of lives

Paul Meier was the one who insisted that fully (as much as possible) test on randomized groups of patients in testing drugs. Everyone else thought it unnecessary because the new drugs were obviously better. What an assumption.

Significance Mag
Today it is standard that such drugs and treatments are tested by a randomised clinical trial. Some patients are given the new treatment, some are given the old; and the decision as to who gets which treatment is made randomly. That tells us whether the new treatment is better than the old one or not. It is also the only real way of finding out. The randomisation part of it is key; without that, it can give unreliable results.

Yet in the 1950s the usual technique was to give a new treatment to the patients whom it was thought would most benefit from it. It frequently happened that those were the patients whose chances of recovery were the best in any case, under the existing treatments as well as the new one. The result was all too often that new treatments were thought to be better than old ones but in fact were not.

‘When I said “randomize” in breast cancer trials I was looked at with amazement by my clinical colleagues’ said Meier in an interview in 2004. ‘ “Randomize? We know this treatment is better than that one” they said. I said “Not really…” ’ That drugs are now rigorously tested, and that those tests give good and unbiased evidence for or against their effectiveness, is in very large part due to Meier.

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