A premature infant is born with a form of severe lung injury that carries a 20% chance of survival. Her physician decides to throw a medical “Hail Mary” and try an untested adult technique to bypass the injured lungs. The infant survives, and after a few more tries, the physician realizes that the survival rate may be as high as 80% with this new treatment. Does he know enough that the treatment should become standard practice, or is a randomized clinical trial required?
In modern medicine, randomized clinical trials (RCTs) are a very effective way to determine the efficacy of different treatments. In an RCT, patients are randomly assigned to receive one of the treatments under study, and the differences in their outcomes are measured. Randomization can be a very helpful tool to minimize the impact of confounding factors, so that scientists can be as confident as possible that any differences between the groups are due to the treatments and nothing else.
