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The uncertainty principle
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For a randomised trial to be ethically valid there should be uncertainty about which of the treatments concerned is better. If there is complete uncertainty, there should be an equal chance of either outcome and half of all trials should favour the new treatment and half the control treatment. Deviation from this equipoise would suggest either bias or poor quality trials. (This argument is, of course, an absolutist argument in that it insists on complete uncertainty. You might, …