Platform Trials — Beware the Noncomparable Control Group

Double-blind active-control trials: beware the comparator you keep.

The indirect impact of the known comparator drug in double-blind comparative clinical trials of novel agents is underappreciated, despite its potentially pernicious effects. This hypothesis-generating analysis illustrates potential spillover effects of a comparator (amphotericin) in the evaluation of the first member (caspofungin) of a novel class (echinocandins) of antifungal drugs. Reported r...

Allocating Awards Across Noncomparable Categories

Suppose an agency awards a ...xed number of prizes to applicants in di¤erent categories such that the applicant-to-winner ratio is constant by category. It is demonstrated in a simple theoretical model that the number of awards in a category will typically be positively related to the degree of applicant uncertainty. The theoretical ...ndings are related to awards data from the Social Sciences ...

Beware of the venous return in cardiovascular control.

TO THE EDITOR: Cannesson et al. (1) hypothesize that the effect of phenylephrine (PE) on cardiac output (CO) is dependent on the volume state of the cardiovascular system. This system may be dependent or independent of volume assessed from increase in CO by fluid bolus. In the independent state, PE decreases CO explained by increased afterload. In the dependent state, PE increases CO explained ...

The efficacy paradox in randomized controlled trials of CAM and elsewhere: beware of the placebo trap.

Beware the Masquerading Malignancy

1 Parviz L. Sadigh, MB ChB Seng-Feng Jeng, MD E-Da Hospital I-Shou University Kaohsiung, Taiwan Sir: A plastic surgeons we often find ourselves operating on all parts of the human body. Indeed, it is this variation, unparalleled among the other surgical specialties, that stands Plastic Surgery out and makes for such a fascinating and captivating choice of career. It is important to remember, ho...