Reviews for Chasing Medical Miracles: The Promise and Perils of Clinical Trials

The average rating for Chasing Medical Miracles: The Promise and Perils of Clinical Trials based on 2 reviews is 3.5 stars.

Review # 1 was written on 2009-07-15 00:00:00 Mike Xigarevidh very good, balanced overview of clinical trials (medical ones anyway -- doesn't discuss psychotherapy trials). Author does not focus much on the scientific aspects and did not apparently talk to many investigators, but the experience of subjects (including professional guinea pigs who make it a point to sign up for as many trials as possible to earn money)is highlighted. Also describes very well recent trends and the issues they provoke, such as tendency to shop around for third world countries with less well-developed protections for subjects in order to conduct riskier trials more cheaply, the shift in location of the bulk of trials from universities to freestanding clinical research organizations, the distortions caused by selective publication of favorable results, etc. Poignant final chapter on the author's own experience serving as a subject in a trial regarding islet cell transplanation [he has type 1 diabetes:]. It works only temporarily to free him from insulin dependence, and during the grueling regimen of testing, extra drugs he has to take, etc. his wife leaves him. Remarkably, he still sees the value [mostly to future advances in diabetes care:] of his participation.

Review # 2 was written on 2012-01-28 00:00:00 Juan Franco This book was written by a freelance journalist who was also a longtime diabetic and who participated in a clinical trial investigated the potential of islet cell transplantation in the treatment of diabetes. It provides a comprehensive review of many aspects of clinical trials, including ethical issues, financial issues, studies in Africa as well as his own experience as a subject. Although there are some details that are not completely in context, and some language may have a pejorative slant, the book is relatively balanced and makes very clear an important understanding - clinical trials are not the same as medical treatment. I would encourage people who work in clinical research to read the book. It isn't a long book, and some of the details will be dismissed as ignorance of an 'outsider', but it may help us to do a better job in designing clinical trials and getting the details as far as the subjects right. A couple amusing notes. Explaining the toxicology requirements for testing drugs in people, the authors states that tests must be done in 'two animals'. I'm sure it was an editorial change to remove the important word 'species'. Describing the experiences of a volunteer who had participated in several clinical trials, she had 'had a chunk of her right high removed for testing (?a chunk? or a skin biopsy?) and had more blood drawn than she can remember (compared to regular blood donors?)'. The tedium of long (28 day) studies was well described as was the feeling of being a 'lab rat' on the part of volunteers participating in multiple assessments. It would have been a bit more balanced if the author had acknowledged that the assessments should be validated testing and not simply arbitrary testing and that interest or involvement of the researcher as a subject completes the assessments may bias the result itself. There is an excellent discussion on the differences of philosophy of placebo vs active control. Although the author does quote review articles from medical literature, primarily the NEJM, he doesn't seem to read clinical trials themselves to examine the frequency of adherence to good clinical practice - which would have made his arguments stronger. The author also doesn't make clear that 'dispensing drugs after a clinical trial' in the US and EU is frequently within the context of yet another trial - but a safety trial rather than the original intervention.