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Current Trends in Philosophy of SciencePhilosophy of Science Meets Medicine (Again): A Clearer-Sighted View of the Virtues of Blinding and of Tests for Blinding in Clinical Trials

Current Trends in Philosophy of Science: Philosophy of Science Meets Medicine (Again): A... [A clinical trial is double-blind if neither the administering clinicians nor the participants know to which arm of the trial – experimental or control – any particular participant has been assigned. Double-blinding controls for various possible biases that might otherwise affect the trial’s result; and hence seems to be an unambiguous methodological virtue. And if blinding is a virtue, then so also, it would seem, is testing that blinding was retained throughout the trial’s course. As a matter of fact, however, end-of-trial tests for blinding are relatively seldom performed and, when they are performed, frequently find that blinding has been lost. Rather than decrying this situation, as might have been expected, leaders of Evidence-Based Medicine have become cool, or outright negative, about tests for blinding (and occasionally even about blinding itself). This paper investigates this prima facie mysterious situation from the point of view of the general account of evidence supplied by philosophy of science. It argues that, although interesting and unexpected complexities and difficulties are associated with blinding, the correct response to them is not a negative view of end-of-trial tests for blinding, but rather a nuanced but still positive view.] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

Current Trends in Philosophy of SciencePhilosophy of Science Meets Medicine (Again): A Clearer-Sighted View of the Virtues of Blinding and of Tests for Blinding in Clinical Trials

Part of the Synthese Library Book Series (volume 462)
Editors: Gonzalez, Wenceslao J.
Worrall, John
Current Trends in Philosophy of Science — Jul 26, 2022
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Publisher
Springer International Publishing
Copyright
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022
ISBN
978-3-031-01314-0
Pages
15 –43
DOI
10.1007/978-3-031-01315-7_2
Publisher site
See Chapter on Publisher Site

Abstract

[A clinical trial is double-blind if neither the administering clinicians nor the participants know to which arm of the trial – experimental or control – any particular participant has been assigned. Double-blinding controls for various possible biases that might otherwise affect the trial’s result; and hence seems to be an unambiguous methodological virtue. And if blinding is a virtue, then so also, it would seem, is testing that blinding was retained throughout the trial’s course. As a matter of fact, however, end-of-trial tests for blinding are relatively seldom performed and, when they are performed, frequently find that blinding has been lost. Rather than decrying this situation, as might have been expected, leaders of Evidence-Based Medicine have become cool, or outright negative, about tests for blinding (and occasionally even about blinding itself). This paper investigates this prima facie mysterious situation from the point of view of the general account of evidence supplied by philosophy of science. It argues that, although interesting and unexpected complexities and difficulties are associated with blinding, the correct response to them is not a negative view of end-of-trial tests for blinding, but rather a nuanced but still positive view.]

Published: Jul 26, 2022

Keywords: Clinical trials; Evidence; Blinding; End-of-trial tests for blinding

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