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Biomedical subjects

Iain Chalmers

Publications and source records attributed to Iain Chalmers.

At least 37 records · Page 2Linked to original sources
PubMed2004

Commentary: the 1944 patulin trial: the first properly controlled multicentre trial conducted under the aegis of the British Medical Research Council.

The 1948 report of the British Medical Research Council's randomized trial of streptomycin for pulmonary tuberculosis is widely regarded as marking the beginning of the modern history of controlled clinical trials. Four years earlier, however, a methodologically sophisticated multicentre trial conducted under the aegis of the Medical Research Council was reported, which assessed the effects of the antibiotic patulin on the course of common colds. Philip D'Arcy Hart and Joan Faulkner (later Joan Doll) were the secretary and assistant secretary, respectively, to the committee overseeing the trial, and they clearly recognized the importance of preventing foreknowledge of allocations from those admitting patients to the study. To do this and to 'muddle people up', they and Ruth D'Arcy Hart devised a scheme involving the use of two patulin groups and two placebo groups, allocating patients to one of these four groups using strict rotation. Philip D'Arcy Hart believes that this study has been overshadowed by the celebrated streptomycin trial (for which he was also secretary to the oversight committee) because no beneficial effect of patulin was detected, and because the report of the streptomycin trial referred to the use of random sampling numbers to generate the allocation schedule. This article makes clear why we agree with Philip D'Arcy Hart that the 1944 patulin trial deserves wider recognition as the first well controlled, multicentre clinical trial to have been conducted under the aegis of the British Medical Research Council. This status is reflected in the International Journal of Epidemiology's reproduction of the full text of the trial report in this issue of the journal.

Common Cold↗
PubMed2003

Descriptive survey of non-commercial randomised controlled trials in the United Kingdom, 1980-2002.

OBJECTIVES: To describe the characteristics of randomised controlled trials supported by the main non-commercial sources of funding in the United Kingdom between 1980 and 2002. DESIGN: Descriptive survey. SETTING: Randomised controlled trials funded by the Medical Research Council, NHS research and development programme, Department of Health, Chief Scientist Office in Scotland, and medical research charities. PARTICIPANTS: 1464 randomised controlled trials supported by the main non-commercial sources of funding. RESULTS: Support for randomised controlled trials by the main sources of non-commercial funding in the United Kingdom has fallen in recent years, without any concomitant increase in the sample sizes of these studies. Drug trials in a limited range of health problems have dominated among the studies supported by the Medical Research Council and medical research charities. Until recently, the NHS research and development programme supported randomised controlled trials of various healthcare interventions, in a wide range of health problems, but between 1999 and 2002 many of the subprogrammes that had commissioned trials were discontinued. CONCLUSIONS: The future of non-commercial randomised controlled trials in the United Kingdom has been threatened by the discontinuation or demise of national and regional NHS research and development programmes. Support also seems to be declining from the Medical Research Council and the medical research charities. It is unclear what the future holds for randomised controlled trials that address issues of no interest to industry but are of great importance to patients and practitioners.

Financing, Organized↗
PubMed2003

Provision of consent.

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Clinical Trials as Topic↗
PubMed2002

Discussion sections in reports of controlled trials published in general medical journals.

CONTEXT: Reliable interpretation of the results of a controlled trial entails setting its results in the context of similar research. A previous study showed that most reports of controlled trials published in 5 general medical journals in May 1997 were deficient in this respect. We assessed the extent to which reports of controlled trials published in the same 5 journals discussed new results in light of the totality of evidence from other controlled trials. METHODS: Assessment of the discussion sections in all 33 reports of randomized trials published during May 2001 in Annals of Internal Medicine, BMJ, JAMA, The Lancet, and The New England Journal of Medicine. RESULTS: Three reports appeared to have been the first published trials to address the questions studied. In none of the remaining 30 reports were the results of the new trial discussed in the context of an updated systematic review of other trials. Although reference was made to relevant systematic reviews in 3 of these 30 reports, there was no integration, quantitative or qualitative, of the results of the new trials in an update of these reviews. In the remaining 27 reports, there was no evidence that any systematic attempt had been made to set the new results in the context of previous trials. CONCLUSIONS: Between 1997 and 2001, there was no evidence of progress in the proportion of reports of trials published in general medical journals that discussed the new results within the context of, or with reference to, up-to-date systematic reviews of relevant evidence from other controlled trials.

Evidence-Based Medicine↗