The ongoing debate of blinding in clinical trials

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The ongoing debate of blinding in clinical trials

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Words like ‘placebo’, ‘randomization’ and ‘blinding’ are used as a matter of everyday course and can be confusing for the participant investigating an appropriate clinical trial.

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Blinding

The 21st century has challenged the view that exact science was always accurate, measurable and unbiased. Results are capable of being interpreted in different ways by researchers supporting different hypotheses. There is no perfect method, but some objective steps can be taken to limit researcher bias when assessing studies. Blinding should prompt more objective results as well as more unbiased analyses.

Types of blinding

Usually, trial participants are blinded ensuring that they are not influenced by the beliefs of what is supposed to happen to their bodies or how they’re supposed to feel. Staff administering the treatment, the physician responsible for the assessment of it or the people interpreting results can also be blinded. Wholesale blinding of as many individuals as is recently practicable should limit bias in clinical trials. However, this is perhaps considered to be too simplistic and researchers should expressly state which individuals in the trial were blinded, how this was achieved and whether they tested the success of the blinding process.

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At this point, the debate as to the efficacy of blinding can fairly be said to be ongoing. Detailed studies have flagged that the potential impact of people’s beliefs needs to be considered and that blinding can make trials unnecessarily complex leading to participant reluctance or drop out. Blinding can also be elaborate and expensive.

Whilst assessment of bias at all stages in the trial is vital, the importance of disclosing the results of clinical trials cannot be underplayed as this leads to an incomplete and potentially misleading overview of the benefits and risks of treatments.

Leaving the blinding debate aside, there will always be found a willing supply of clinical trial volunteers. Motivated by personal medical interest, altruism or financial reward, there are many medical organizations answering the question of how can I be a clinical trial volunteer? that are looking for patient volunteers to participate in paid medical trials.

Computer simulation and animal testing can only tell us so much as to how a new treatment might work but are no substitute for testing on a living human body and most modern medical treatments are a direct result of clinical research.

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