title: [Reflections on therapeutic trials].
abstract: The approach of establishing a relationship between cause and effect is a form of research contrary to the empirism which characterises many therapeutic trials. This empirism may result in certain embarrassing situations when the criteria of evaluation do not turn out to have the value that simple correlations attribute to them. Evaluating the efficacy of a drug whilst ignoring its mechanisms of action is courting danger, especially that of being unable to pursue a line of research when the global results are known in advance. These phenomena, observed in the example of the prevention of sudden death by antiarrhythmic drugs and betablockers, have the effect of impeding research in this complex field and the development of new and potentially useful drugs. It has become necessary to reevaluate the rules of medical experimentation which, in some cases, have reached the limits of feasibility and efficacy.
authors.affiliation: Service de cardiologie, hôpital Lariboisière, Paris.
authors.forename: P
authors.initials: P
authors.lastname: Coumel
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans
vernacular_title: Réflexions sur les essais thérapeutiques.