In Reply We share the enthusiasm expressed by Dr Goldberg and colleagues for advances in genomics, but we disagree with their dismissal of RCTs, a design that has served medicine so well. There is no empirical evidence that -omics allow absolute predictability of treatment effects and outperform treatment discovery in RCTs. Goldberg and colleagues succumb to the gambler’s fallacy (ie, the belief that the effects of treatments can be inferred in unique cases without reference to a reference [class] set), which was refuted convincingly by Bradford Hill more than 60 years ago.
Ioannidis JPA, Hozo I, Djulbegovic B. Study Design and the Drug Development Process—Reply. JAMA. 2014;311(19):2023-2024. doi:10.1001/jama.2014.3829