Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: In response to Drs Boutron and Ravaud,
we suggested that this change in practice was probably due to premature and
unjustified declines in clinicians' and patients' uncertainty about the efficacy
of an experimental treatment. We suggested that this change in assessment
was not based on scientific evidence but, rather, reflected that the treatment
was being tested in a randomized controlled trial.
We also suggested that when a trial is not blinded, clinicians' impressions
(right or wrong) of an emerging favorable trend might further increase their
use of the experimental treatment. Boutron and Ravaud have suggested the additional
term "jumping ahead" for this phenomenon. Although we remain unconvinced that
our observations support their proposal, we look forward to future studies
to determine how often jumping the gun occurs in concert with randomized trials
in other fields.
Clark WF, Garg AX, Blake PG, Sackett DL. Premature Application of Trial Results to Clinical Practice. JAMA. 2003;290(23):3072. doi:10.1001/jama.290.23.3072-a