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ALS: Derek Angus
February 24 @ 3:30 pm - 5:30 pm EST
Title: The RCT is dead. Long live the RCT.
Abstract:
First introduced in the 1940s, the randomized clinical trial, or RCT, revolutionized medicine. Today, all new therapies must show efficacy in an RCT to gain regulatory approval, fueling a clinical trials industry of over $50 billion per year. Although deemed essential, RCTs have considerable statistical, logistical, and ethical challenges. There are some solutions, but few have been adopted. Consequently, RCT design and execution remains largely unchanged in decades, and increasingly anachronistic. I will discuss some of the challenges with RCTs, review some solutions ushered in by necessity during COVID, and consider some next steps. Some key themes I will discuss include frequentist versus Bayesian inference, heterogeneity of treatment effect, use of adaptive platform designs, the implications of digitized health records, and whether and how clinical care should be fused with knowledge generation under conditions of uncertainty.
This talk will also be available live streamed on You Tube at https://www.youtube.com/channel/UCrRp47ZMXD7NXO3a9Gyh2sg.