Testing Treatments: Better Research for Better Healthcare - Softcover

How do we know whether a particular drug, therapy or operation really works, and how well? How reliable is the clinical evidence? Are clinical trials truly unbiased? And is current research fully focused on the real needs of patients? Such timely and pressing questions are raised and resolved in this probing inquiry into modern clinical research, with far-reaching implications for daily medical practice and patient care. What emerges is the surprising truth that clinical research is neither as unbiased, nor as relevant as patients have every right to expect, but that everyone - patients, doctors and researchers - can do much to change current practice and achieve better healthcare. Aimed at both patients and professionals, "Testing Treatments" builds a lively and thought-provoking argument for better, more reliable, more relevant research, with unbiased or 'fair' trials, and explains how patients can work with doctors to achieve this vital goal. Expertly and thoroughly researched, but never dry or dull, the fast-moving commentary, spanning the gamut of illness and therapy - from mastectomy to thalidomide - explores a vast range of revealing case-studies, enlivened throughout by entertaining anecdotes and vivid eyewitness accounts drawn from the direct experience of patients, practitioners and researchers. As the evidence unfolds, it becomes glaringly obvious how some treatments have been at best inadequate, at worst harmful, and how inadequately tested many treatments remain. While outlining the goals of good research and how best to achieve unbiased results, including the use of randomised clinical trials, the authors also highlight the inevitable uncertainties surrounding the effects of treatment, as well as the commercial and academic interests that invariably shape what research gets done. Often startling, at times unsettling, "Testing Treatments" nonetheless remains essentially pragmatic and constructive in tone, urging everyone to take an active part in changing conditions, and describing what practical steps doctors and patients can together take to improve current research and future treatment. "Testing Treatments" should appeal to everyone who wants to join the revolution to reform clinical research, to ensure that it really does serve the interests of patients. Sometimes shocking but never pessimistic, "Testing Treatments" challenges us all to help make a difference.

Imogen Evans practised and lectured in medicine in Canada and the UK before turning to medical journalism at The Lancet. From 1996 to 2005 she worked for the Medical Research Council, latterly in research ethics, and has represented the UK government on the Council of Europe Biomedical Ethics Committee. Hazel Thornton, after undergoing routine mammography, was invited to join a clinical trial, but the inadequate patient information led to her refusal. However, it also encouraged her advocacy for public involvement in research to achieve outcomes relevant to patients; she has written and spoken extensively on this topic. Iain Chalmers practised medicine in the UK and Palestine before becoming a health services researcher and directing the National Perinatal Epidemiology Unit and then the UK Cochrane Centre. Since 2002 he has led the James Lind Initiative, promoting better controlled trials for better health care, particularly through greater public involvement.