PubMed · 11643278
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Elvin A Kabat. 1975-08-15. Ethics and the wrong answer.. https://doi.org/10.1126/science.11643278
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BACKGROUND: Randomised controlled clinical trials are performed to resolve uncertainty concerning comparator interventions. Appropriate acknowledgment of uncertainty enables the concurrent achievement of two goals : the acquisition of valuable scientific knowledge and an optimum treatment choice for the patient-participant. The ethical recruitment of patients requires the presence of clinical equipoise. This involves the appropriate choice of a control intervention, particularly when unapproved drugs or innovative interventions are being evaluated. DISCUSSION: We argue that the choice of a control intervention should be supported by a systematic review of the relevant literature and, where necessary, solicitation of the informed beliefs of clinical experts through formal surveys and publication of the proposed trial's protocol. SUMMARY: When clinical equipoise is present, physicians may confidently propose trial enrollment to their eligible patients as an act of therapeutic beneficence.
DESIGN AND METHODS: We studied serum levels of IGF-I and IGFBP-3 in 68 pregnant women; 28 mild preeclampsia, 13 severe preeclampsia, and 27 healthy pregnant control subjects. RESULTS: When compared with the healthy pregnant group preeclampsia groups had markedly decreased mean serum IGF-I levels. The difference was also significant between the mild and severe preeclampsia groups. Serum mean IGFBP-3 level was also lower in both preeclampsia groups than in healthy pregnancy group, but the difference between the preeclampsia groups did not reach significance. For IGF-I/IGFBP-3 ratio, the mean levels were significantly lower in mild and severe preeclampsia groups than in healthy pregnancy group. Also the mean IGF-I/IGFBP-3 ratio was significantly lower in the severe preeclampsia group compared with the mild preeclampsia group. CONCLUSIONS: IGF-1 and IGFBP-3 levels in patients with preeclampsia were compared with healthy pregnant control subjects. IGF-I and IGF-I/IGFBP-3 ratio may be useful for estimate the severity of preeclampsia.