From Australian Doctor, 21 November 2014:
When Archie Cochrane attempted what he later described as his “first, worst and most successful clinical trial” among fellow prisoners of war in World War II suffering from jaundice and oedema, he might have been reassured that whatever the outcomes of his efforts, the majority of his study subjects stood a good chance of surviving. His clumsy attempt, treating some with yeast and others with vitamin C tablets, laid the foundations for what has now become the gold standard for clinical trials in western medicine: the randomised, placebo-controlled trial.
One wonders what Cochrane might have done, had he instead found himself in West Africa during the current Ebola virus epidemic.
Ebola is breaking all sorts of unpleasant records in terms of its casualties and spread, but it is also demanding an urgent rethink of many of the fundamental tenets of western medicine that have been the greatest part of Cochrane’s legacy.
“The Ebola epidemic is an extraordinary situation, it’s a public health emergency of international concern,” says Professor Michael Selgelid, director of the Centre for Human Bioethics and the WHO Collaborating Centre for Bioethics.
With models predicting horrific scenarios should the epidemic not be brought under control, unprecedented measures are being taken to bring potential treatments and vaccines to the field. Unfortunately, at the start of this epidemic, none had been tested—successfully or otherwise—in humans.
The situation has forced the medical community’s hand and for the first time experimental, unregistered, and untested medications are being used in patients with Ebola. Read more (Australian Doctor registered users only).
Bianca Nogrady 