DISCUSSION: The difference between theoretical and clinical equipoise is this: theoretical equipoise requires strict neutrality. Clinical equipoise allows you to have an opinion as long as a substantial part of the community thinks otherwise.
How to violate theoretical equipoise: Not being neutral.
How to violate clinical equipoise: Not being neutral AND not believing that some of the medical community disagrees.
I should clarify about clinical equipoise. It doesn’t work if there is no disagreement. The reason you can have a bias under clinical equipoise is that you recognize that some part of the community disagrees with you. So if no part of the community thinks the other drug is better, clinical equipoise is impossible.
Neutrality is permissible under both standards. Neutrality does not violate clinical equipoise!
___________
- This might violate both types of equipoise. Clinical equipoise requires disagreement. Here the results are so striking that it sounds like few researchers favor the second treatment. (“Most” can include “all” or “almost all”.)
- This trial sounds like it meets the standards of both theoretical and clinical equipoise. If both treatments seem equal, then it’s possible for researchers to be neutral.
- This violates theoretical equipoise. Researchers are required to be neutral. This also may violate clinical equipoise. If scientists aren’t neutral, then clinical equipoise requires part of the community to disagree about what treatment is best. See lines 48-50.
- CORRECT. This definitely violates theoretical equipoise. That requires strict neutrality.
However, this likely does not violate clinical equipoise. Clinical equipoise allows researchers to have an opinion, as long as they recognize that part of the community disagrees with them. See the final paragraph, especially lines 48-50 and 53-56. - If physicians in the trial think the treatments are equal, then these physicians are neutral. So they meet the standards of both types of equipoise.
gymnajoy says
Hi!!!! Thank you for your CLEAR explanation!!!!!!!
Founder Graeme Blake says
Thanks! So glad you liked it.