Medical Proofs, Social Experiments
Clinical Trials in Shifting Contexts
Clinical trials have become key technologies for decision making in the contemporary world. Their results shape medical practice and determine priorities across health care systems, but the work that goes into producing credible data is often hidden. Medical Proofs, Social Experiments draws upon detailed case studies to argue that to understand their value, we need to pay more attention to the contexts for these modern medical experiments, recovering the diverse ways in which they involve doctors, patients and the public, the local practices that contribute to their completion, and the complex negotiation of their results in professional and statutory institutions. Presenting research from the UK, USA, Sweden and The Netherlands, the ethnographic perspective adopted by the authors provides a space to explore the investments of different state, market, professional and other actors in particular forms of evaluation, and the ways in which trial methodologies may be re-designed or re-imagined to satisfy social and political expectations. As such, this volume will be of interest to those working in the fields of science and technology studies, the sociology and anthropology of medicine and researchers of policy and organisation in health care.
Table of Contents
Chapter 1 Introduction, Catherine Will, Tiago Moreira; Part I The Practices of Research; Chapter 1a Reconciling Research with Medical Care in RCTs, Stefan Timmermans; Chapter 2 Bridging the Ontological Divide: Different Social Worlds in the Conduct of a Pilot Study, Ben Heaven; Chapter 3 From Dirty Data to Credible Scientific Evidence: Some Practices Used to Clean Data in Large Randomised Clinical Trials, Claes-Fredrik Helgesson; Part II Framing Collective Interpretation; Chapter 4 Addressing the Commercial Context: The Collective Critique of Clinical Trials, Catherine Will; Chapter 5 When are Trials Not Enough? Clinical Versus Cost-effectiveness in the Controversy Over Access to Dementia Drugs in the NHS, Tiago Moreira; Part III Testing the Limits for Policy; Chapter 6 Comparing Artificial Groups: On the History and Assumptions of the Randomised Controlled Trial, Trudy Dehue; Chapter 7 Pragmatic Fact-making: Contracts and Contexts in the UK and the Gambia, Ann Kelly; Chapter 8 Trial, Trial, Trial Again: Reconstructing the Gold Standard in the Science of Prostate Cancer Detection, Alex Faulkner; Chapter 10 Conclusion: So What?, Tiago Moreira, Catherine Will;
Catherine Will lectures in Sociology at the University of Sussex, UK.
Tiago Moreira lectures in the School of Social Sciences at Durham University, UK.
'At a time when "evidence" has become central to debates about healthcare and rationing, this important book brings together valuable studies that show how contingent and complex the construction of evidence in clinical trials really is.' Carl May, Newcastle University, UK 'Relying upon detailed multidisciplinary investigations of clinical trials, this highly original book provides illuminating insights into the ongoing (silent) transformation of our societies into evidence-based societies.' Michel Callon, Mines Paris Tech, France
'... an excellent book that should and will find readership not only as a seminal collection on clinical trials but also as a locus for broader debate in the sociology of health and illness, political sociology, and science and technology studies.' Network, the Magazine of the British Sociological Association
'The real strength of this book is the brilliant use of real life examples to illustrate its key points... examples demonstrate the social reality in which clinical trials are carried out and the challenges that this generates. The large number of contributing authors means that each issue is tackled from a slightly different perspective resulting in a rich set of ideas and philosophies. Most importantly, the sociological research described in this book provides not only a means by which to criticize the limitations of RCTs, as has been done countless times before, but also as a way to better understand the evidence that they generate and to provide solutions to some of these limitations. Because of the breadth of information provided and the importance of the subject matter, this book will be of interest to anyone involved in the generation or application of medical evidence.' Health Sociology Review