Advantages of Using Lotteries to Select Participants for High-Demand Covid-19 Treatment Trials.

Autor: Iyer AA; Fellow in the Department of Bioethics at the National Institutes of Health (NIH) Clinical Center., Hendriks S; Bioethicist in the Department of Bioethics at the National Institutes of Health Clinical Center., Rid A; Bioethicist in the Department of Bioethics at the National Institutes of Health Clinical Center.
Jazyk: angličtina
Zdroj: Ethics & human research [Ethics Hum Res] 2020 Jul; Vol. 42 (4), pp. 35-40. Date of Electronic Publication: 2020 Jun 22.
DOI: 10.1002/eahr.500061
Abstrakt: As hospitals have experienced a surge of Covid-19 patients, investigators of Covid-19 treatment trials face a difficult problem: when an institution has more eligible and interested patients than trial slots, who should be enrolled? Defining a clear strategy for selecting participants for "high-demand" Covid-19 treatment trials is important to avoid ad hoc and potentially biased decision-making by local investigators, which could inadvertently compromise a trial's social value, participants' interests, or fairness. In this article, we propose a set of ethical criteria for evaluating participant-selection strategies for such trials. We argue that the pandemic context-in particular, great urgency to develop safe and effective treatments, uncertainty surrounding Covid-19, and strain on the health care system that limits the time and effort available for trial enrollment-favors participant-selection strategies that optimize the ease of enrollment and, ideally, social value. A lottery and, where possible, a weighted lottery have important advantages in these respects.
(Published 2020. This article is a U.S. Government work and is in the public domain in the USA.)
Databáze: MEDLINE
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