Cover: The Decision to Initiate Clinical Trials of Current Medical Practices

The Decision to Initiate Clinical Trials of Current Medical Practices

Published 1985

by James P. Kahan, C. Richard Neu, Glenn T. Hammons, Bruce J. Hillman


Download eBook for Free

FormatFile SizeNotes
PDF file 5.5 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.


Purchase Print Copy

 Format Price
Add to Cart Paperback118 pages $30.00

This report examines the decisionmaking process by which the National Institutes of Health (NIH) initiates a randomized clinical trial of a medical practice in current use, i.e., treatment, diagnostic, and preventive practices, including procedures and the use of devices and drugs, that are currently used routinely by some fraction of the practitioner community and are not regarded as experimental. The report's central concern is how NIH decides to initiate clinical trials of the evaluation of problematic current medical practices and how well NIH's approach works. A three-step model describes the NIH decisionmaking process. Each of the three steps — awareness, relevance, and feasibility — is constructed from a number of dimensions. The model suggests three questions of potential policy importance: (1) Does the NIH have a uniform process for deciding whether to initiate clinical trials of current practices? (2) Is there an adequate system for identifying questionable current medical practices? (3) How should clinical trials on questions of the cost effectiveness of medical practices be sponsored?

This report is part of the RAND report series. The report was a product of RAND from 1948 to 1993 that represented the principal publication documenting and transmitting RAND's major research findings and final research.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.