Theoretical vs. Clinical Equipoise

Answer choices

1. A

   Correct46% picked this

   In most comparative clinical trials, the main purpose is to prove definitively that a treatment considered best by a consensus of relevant experts is

   Why this is right

   This answer primarily goes against the claim towards the beginning of the 3rd paragraph that "equipoise would impose rigorous ethical standards without unreasonably constricting them". This answer choice makes it sound like clinical equipoise (just like theoretical) would still make it an ethical problem for physicians to take part in most comparative drug trials. Clinical equipoise allows physicians to participate when the medical community at large is still undecided which of two treatments is better. But if, as this answer says, most comparative trials are pitting one drug (considered best by a consensus of medical experts) vs. another drug, then participating physicians would not be in a state of clinical equipoise. If there's a consensus in the medical community, then clinical equipoise is impossible. It requires (as the end of the 3rd paragraph says) that medical experts are divided as to which treatment is better. So this answer choice weakens by showing that clinical equipoise would also not be possible for most comparative trials; thus, it's not clear that it's any better than theoretical equipoise.

   Skill tested: Weaken · how this choice captures the passage's function is the move to repeat next time.

   46%
2. B

   Do vs. Should7% picked this

   Physicians participating in comparative clinical trials rarely ask to leave the trials because early data favors one of the

   Whether physicians rarely or frequently do ask to leave trials is kind of beside the point. If we use a standard of theoretical equipoise, then physicians often should be asking to leave a trial because they've started to form a judgment on which treatment is superior. This answer is also suspicious since it's borrowing language from the 2nd paragraph, which was where we talked about why theoretical equipoise was problematic.

   7%
3. C

   Unclear Impact7% picked this

   The number of comparative clinical trials that are conducted annually is increasing rapidly, but the level of ethical oversight

   In a sense, we might say this strengthens the author's case for using clinical equipoise, since it's an easier ethical standard to meet than theoretical equipoise is. If we're conducting more and more comparative trials, then we're going to need an ethical standard that is more frequently attainable.

   7%
4. D

   No Impact7% picked this

   Medical ethicists are more inclined than are clinical researchers to favor an ethical requirement based on theoretical equipoise over

   Given that theoretical equipoise is the tougher ethical standard (but hard to pull off in practice), it's unsurprising to hear that ethicists like it more than researchers. Ethicists are more likely to think about what would be great in an ideal world, whereas the author is trying to sell clinical equipoise based on the realities of what takes place in the real world. The author surely realizes that his idea will probably be embraced more by practicing physicians than by ethicists, so this answer isn't really hurting his feelings too much.

   7%
5. E

   Not as Good as (A)33% picked this

   In clinical trials comparing two treatments, it rarely occurs that researchers who begin the trial with no preference for either of the treatments later

   This answer choice makes it sound like one of the ways in which theoretical equipoise could be destroyed (no preference at first, but early data leads to a strong preference) is a rare occurrence. In other words, this answer makes it seem like one of the potential problems associated with theoretical equipoise is pretty rare. However, this answer is saying it's rare that the researchers develop a strong preference on the basis of early data. There's still plenty of room for them to develop some preference on the basis of early data. And there's plenty of room for them to develop a moderate / strong preference based on data obtained in the middle of the study. So even once you accept that the specific dealbreaker for theoretical equipoise described in this answer is rare, you still have many possible cases in which theoretical equipoise could be a frequent dealbreaker.

   33%