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Support and the Ethics of Study Implementation

Lessons for Comparative Effectiveness Research from the Trial of Oxygen Therapy for Premature Babies

Bibliographic Data

ID20333353
AuthorsJohn D Lantos (0000-0002-6553-3874), Chris Feudtner (0000-0002-5879-0434)
Year2015
Volume45
Issue1
Pages30-40
Publication date2015-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueThe Hastings Center Report (JOURNAL)
Journal identifiersISSN: 0093-0334 • E-ISSN: 1552-146X
PublisherWiley (PUBLISHER • GB)
DOI10.1002/hast.407
PMID25530316
OpenAlexW1966854747
LanguageEN
Citations received4
References cited13

The Surfactant, Positive Pressure, and Oxygenation Randomized Trial (SUPPORT) has been the focal point of many different criticisms regarding the ethics of the study ever since publication of the trial's findings in 2010 and 2012. In this article, we focus on a concern that the technical design and implementation details of the study were ethically flawed. While the federal Office Human Research Protections focused on the consent form, rather than on the study design and implementation, OHRP's critiques of the consent form reveal views about the study design and implementation that we believe are fundamentally flawed. These criticisms about the design and implementation of SUPPORT, if generalized, become relevant concerns about these aspects of many comparative effectiveness research studies . Our analytical approach will be to use SUPPORT as a prime example of comparative effectiveness research and show why it challenges some prevailing assumptions about the riskiness of research. We will address five aspects of the study design and implementation: 1) randomization, 2) treatment by protocol, 3) choice of endpoints, 4) lack of a “standard care” control group, and 5) the use of altered oximeters. Examining these aspects will allow us to answer two specific central questions. The first is a methodological question with ethical implications: was the study designed in such a way as to answer the primary study question? The second question is whether the study design added or decreased risk to the babies enrolled in the study compared to babies who were not in the study

Alternative medicine · Bioethics · Clinical study design · Clinical trial · Comparative effectiveness research · Engineering ethics · Health care · Informed consent · Medical education · Political science · Protocol (science) · Randomized controlled trial · Research design · Research ethics · Social science · Sociology · Childhood Cancer Survivors' Quality of Life · Congenital Heart Disease Studies · Engineering · Law · Medicine · Neonatal Respiratory Health Research · Psychology

  • Support

    Open Access•Robert M Nelson•The Hastings Center Report•2015

  • The Controversy over Support Continues and the Hyperbole Increases

    Open Access•Alan R Fleischman•The Hastings Center Report•2015

  • Support and Comparative Effectiveness Trials

    Open Access•Lois Shepherd•The Hastings Center Report•2015

  • Clinical Trial Portfolios

    Open Access•Alex John London, Jonathan Kimmelman•The Hastings Center Report•2019

  • Ethics and Informed Consent for Comparative Effectiveness Research With Prospective Electronic Clinical Data

    Ruth Faden, Norman Ka et al.•Medical Care•2013

Unique citing works4
Citations per year0,36
Citation span2015 - 2019 (5)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 4

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Open DOISci-HubOpen Access
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