PROMISING TREATMENT
Boston Interhospital Virus Study Group
It is often suggested that controlled trials of promising treatments are unwarranted in conditions of very high mortality; severe respiratory distress syndrome has been used as an example. This is completely logical if the arguments are confined to the category of inevitably fatal conditions, but the situation is rarely this simple.
A Boston group wrote about this issue as follows:
"Patients with severe and fatal . . . disease merely represent the ‘tip of an iceberg’ for there are almost always many more with milder or even asymptomatic processes. Furthermore, the increased interest in diagnosis that accompanies the introduction of any new mode of therapy invariably results in the recognition of less severe cases that would previously have gone undiagnosed. Consequently, there is sure to be a lower morbidity and mortality in currently treated patients than in otherwise comparable historical controls, even when the treatment is without effect or actually deleterious."
