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Author(s) -
Relman Arnold S.
Publication year - 1979
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1979255part2673
Subject(s) - hierarchy , control (management) , identification (biology) , clinical trial , rank (graph theory) , public relations , business , randomized controlled trial , medicine , medical education , political science , law , management , economics , surgery , botany , mathematics , pathology , combinatorics , biology
Major clinical trials are usually large projects involving many institutions and large numbers of individuals. They are often administered as contracts rather than as research grants, with all the attendant centralization of control that this arrangement implies. Whether supported by contract or grant, however, the typical large trial in this country tends to be an elaborately organized enterprise replete with prearranged guidelines, staff assistants, expert consultants, and a panoply of committees, each concerned with a particular aspect of the project. Personal identification with such projects therefore tends at best to be limited to a few leading spirits, whereas the association of most of the other participants is so tenuous as to be virtually invisible. Furthermore, the role of the rank‐and‐file collaborator is often quite different from that of the few at the top of the administrative hierarchy. As Cochrane 1 observed some years ago, “a randomized c1inical trial is great fun for the coordinator but can be very boring for the physicians filling in the forms.”