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June 18, 1997

Clinical Trials Seek Proof of Efficacy

JAMA. 1997;277(23):1827. doi:10.1001/jama.1997.03540470009003

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WHEN BROTHER Cadfael prescribed herbs and simples to heal his patients in Ellis Peters' popular medieval mystery series, it's safe to say he didn't worry about obtaining consent and setting up a control group of fasting monks or fainting maidens. If the remedies worked then they worked, and praise the Lord. The gratitude of patients (and rarely a fat purse) was Cadfael's reward.

The conduct of 20th-century research on pharmaceuticals and therapies for still extant ancient ailments, as well as newer disorders, would surprise the good friar. The potential profitability of finding the most efficacious treatment for a disease would astound and perhaps trouble him. But his deep understanding of human nature would no doubt carry the day. It might even shed some light on how to approach maladies experts can't agree on how to fight and point the way to making clinical trials—the subject of this Contempo issue's MEDICAL