of Economics and Political Science Erik Snowberg
When a new type of drug or therapy is discovered, double-blind randomized controlled trials (DBRCTs) are the gold standard for evaluating them. These trials, which have been used for years, were designed to determine the true efficacy of a treatment free from patient or doctor bias, but they do not factor in the effects that patient behaviors, such as diet and lifestyle choices, can have on the tested treatment. A recent meta-analysis of six such clinical trials, led by Caltech's Erik Snowberg , professor of economics and political science, and his colleagues Sylvain Chassang from Princeton University and Ben Seymour from Cambridge University, shows that behavior can have a serious impact on the effectiveness of a treatment-and that the currently used DBRCT procedures may not be able to assess the effects of behavior on the treatment. To solve this, the researchers propose a new trial design, called a two-by-two trial, that can account for behavior-treatment interactions. The study was published online on June 10 in the journal PLOS ONE. Patients behave in different ways during a trial. These behaviors can directly relate to the trial-for example, one patient who believes the drug may religiously stick to his or her treatment regimen while someone more skeptical might skip a few doses.
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