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In Reply Dr Folayan and colleagues and Mr Kanters and colleagues offer thoughtful responses to my Viewpoint, which advocated for RCTs of therapies against Ebola virus disease and cautioned against compassionate use. Their contrasting criticisms of and support for the use of RCTs demonstrate that consensus on this controversial and emotionally charged question is far off.
Folayan and colleagues correctly note that RCTs should not be performed if sample size constraints due to limited drug availability preclude valid and reliable answers to clinically relevant questions. The ethical requirements for social value and scientific validity, however, are universal and should equally preclude the use of uncontrolled designs if they are likely to yield misleading results.1
Joffe S. Ethical Testing of Experimental Ebola Treatments—Reply. JAMA. 2015;313(4):422. doi:10.1001/jama.2014.17262