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Related Experiment Videos

Cost-benefit considerations in managing oxygenation failure.

A H Morris1

  • 1LDS Hospital, Salt Lake City, UT 84143.

Respiratory Care
|July 1, 1993
PubMed
Summary

Evaluating new intensive care medicine therapies, especially extracorporeal support, requires concurrent controls. Randomized controlled trials are ethically favored for robust evidence in high-technology ICUs.

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Quality & safety in health care·2002

Area of Science:

  • Intensive Care Medicine
  • Clinical Trial Design
  • Medical Technology Evaluation

Background:

  • Evaluating novel therapies in intensive care medicine presents significant challenges.
  • Double-blinded evaluations are often impossible for certain interventions like extracorporeal support.
  • Historical trials, such as the ECMO trial, underscore the necessity of concurrent controls.

Purpose of the Study:

  • To highlight the challenges in evaluating new therapies in intensive care medicine.
  • To advocate for the ethical and scientific necessity of controlled trials.
  • To emphasize the importance of concurrent controls in clinical research.

Main Methods:

  • Discussion of challenges in non-blinded therapy evaluation.
  • Ethical considerations for randomized controlled trials (RCTs).
  • Proposal for establishing ICU human laboratories.

Main Results:

  • Extracorporeal clinical trials demonstrate the importance of concurrent controls.
  • Ethical objections to controlled trials without credible data are questionable.
  • Randomized controlled trials offer a stronger ethical basis for therapy evaluation.

Conclusions:

  • Concurrent controls are crucial for evaluating therapies in intensive care medicine.
  • Randomized controlled trials are ethically justifiable and scientifically sound, particularly in high-technology ICUs.
  • ICU human laboratories are essential for advancing therapeutic understanding and identifying effective treatments.

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