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Caution on clinical trials

March 18, 2009

Re "Clinical research lacks for patients," March 14

The Times' article misses a key point: There are too many clinical trials.

As a biomedical research administrator, I know that many incentives for clinical trials are institutional, not scientific. Organizations are often evaluated on the number of trials they perform, clinical faculty must conduct trials to be promoted, and donors are more likely to contribute if a discovery is tested on patients rather than going through years of (necessary) study in fruit flies or mice.

The genetic revolution of the 1990s brought great hope for new cures. But much like opening a set of Russian nesting dolls, this revolution revealed new complexity. It is time for the biomedical research system to adjust to reality and focus on long-term scientific research, rather than rush therapies into premature and expensive clinical trials.

David Rubenson

Los Angeles

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Were I a patient with cancer or a degenerative neurological condition, I probably would not sign up for a clinical trial. Most require a double-blind technique in which a control group receives no therapy, apart from the basic standard and saline or sugar pills.

After 60 years as a physician, I'm all for clinical research. But were I afflicted with a serious illness, I'd want my oncologist to go for broke.

What's more, some dubious clinics use "clinical research" as a means of trolling for patients. Their clinical research is largely unregulated, and I wonder if they are more dedicated to volume and remuneration than valid clinical data.

Clinical research can be a jungle, requiring the guidance of a trusted, ethical physician. The patient with a serious disease needs be wary.

Roy L. Byrnes MD

San Juan Capistrano

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