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Comment & Response |

Ethical Testing of Experimental Ebola Treatments—Reply

Steven Joffe, MD, MPH1
[+] Author Affiliations
1Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia
JAMA. 2015;313(4):422. doi:10.1001/jama.2014.17262.
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In Reply Dr Folayan and colleagues and Mr Kanters and colleagues offer thoughtful responses to my Viewpoint, which advocated for RCTs of therapies against Ebola virus disease and cautioned against compassionate use. Their contrasting criticisms of and support for the use of RCTs demonstrate that consensus on this controversial and emotionally charged question is far off.

Folayan and colleagues correctly note that RCTs should not be performed if sample size constraints due to limited drug availability preclude valid and reliable answers to clinically relevant questions. The ethical requirements for social value and scientific validity, however, are universal and should equally preclude the use of uncontrolled designs if they are likely to yield misleading results.1


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January 27, 2015
Morenike Oluwatoyin Folayan, MBChD, MBA, FWACS; Bridget Haire, PhD; Kristin Peterson, PhD
1Obafemi Awolowo University, Ile-Ife, Nigeria
2School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
3Department of Anthropology, University of California, Irvine
JAMA. 2015;313(4):421. doi:10.1001/jama.2014.17256.
January 27, 2015
Steve Kanters, MSc; Kristian Thorlund, PhD; Edward J. Mills, PhD
1School of Population and Public Health, University of British Columbia, Vancouver, Canada
2Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
3Stanford Prevention Research Center, Stanford University, Stanford, California
JAMA. 2015;313(4):421-422. doi:10.1001/jama.2014.17259.
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