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John M. Howard, M.D.
JAMA. 1961;175(8):705-706. doi:10.1001/jama.1961.03040080061017.
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During the past few years, institutions have begun to join in the pooling of their experiences in clinical research. The results have been encouraging, often producing answers in a surprisingly short time.

Historically, individual surgeons have evaluated the natural history of a given disease or the effect of operation in altering its natural course. After a lapse of years, one might have summarized and reported his observations. Other surgeons might have reported various modifications with divergent results. As a result, after a generation can anyone tell whether postoperative irradiation influences the course of breast cancer? Can anyone outline with factual assurance the course and treatment of gastric ulcer, of thyroid malignancy, of pancreatitis or of recurring tonsillitis, contaminated wounds, or ruptured disc? The answer is NO. Prejudiced, incomplete, or noncomparable reports often fail to answer any single question.

Currently, a revival and extension of inter-institutional clinical research has occurred which


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