Tropical trials and tribulations.

نویسندگان

A J Hall

P Aaby

چکیده

Field trials are the cornerstone in the evaluation of new public health interventions in the developing world. There is a tendency to base the introduction of new public health measures on very few trials. This is understandable given the expense in terms of money and time in mounting these trials and the enthusiasm to do something about the persistently high mortality in many parts of the world. However in the conduct of vaccine trials in West Africa a number of problems of design and analysis have presented themselves. These problems do not seem to be widely recognized but they affect the design of new trials and the interpretation of those already published. Some of these points are relevant to other forms of intervention study, such as vitamin A supplementation, and to trials in any part of the world. They fall into three broad areas; randomization, speculative versus practical trials and outcome measurement.

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