The organising of clinical trials and the reliability of knowledge
May 3 2010
Venue: Conferemnce Room, Ground Floor, David Hume Tower, George Square, Edinburgh.
Organised by: ESRC Innogen Centre, University of Edinburgh
PLEASE NOTE CHANGE OF VENUE DUE TO REFURBISHMENT WORKS, THIS EVENT WILL BE HELD IN THE CONFERENCE ROOM, GROUND FLOOR, DAVID HUME TOWER, GEORGE SQUARE
**ATTENDEES MUST PRE-REGISTER FOR THIS SEMINAR**
To register - please email Angela.McEwan@ed.ac.uk or call 0131 650 9113
2.30-5pm **PLEASE NOTE EARLIER START TIME THAN USUAL**
Dr Ben Toth
Clinical trials and the social order of medicine
The history of clinical trials can be told in terms of efforts to increase the authority of the results of trials by informing their design with statistical techniques. There is another history though, one in which the design of trials, including the statistical techniques deployed, is connected to the social order of medicine. This paper considers three case studies. The first is a series of trials organised by the British Medical Association in the 1860s at a time when it was trying to establish the legitimacy of its knowledge and the code of conduct for its members. The second is the work of the Medical Research Council Therapeutic Trials Committee in the 1930s. This committee organised trials of the drugs being produced by the emerging British pharmaceutical industry. The third case study is the clinical trial of streptomycin as a treatment for tuberculosis, organised by the Medical Research Council and published in 1948, sometimes said to be the first clinical trial to use a well founded methodology. I will argue that the design of clinical trials says as much about the structure of medical organisation as it does about scientific methodology. In the case of the BMA and streptomycin, design was statistical in character. In the case of the Therapeutic Trials Committee it was not, illustrating the contingency of statistical techniques in the legitimation of knowledge about therapeutics.
Prof Claes-Fredrik Helgesson
On the organising of large clinical trials: How mundane co-ordination might have epistemic outcomes
How can the mundane organising of large-scale clinical trials have epistemic outcomes? The presentation reports on a research project involving some 60 days of fieldwork in different sites of a few phase III and IV clinical trials for testing pharmaceuticals. At the centre of the interest are the practices of coordination within the trials and how they assist in converting what is spatially and temporally scattered into condensed results having a significant scientific authority. A central argument is that the distributed character of large clinical trials is of prime importance. The distances between different sites of a trial are not only obstacles to be overcome. They also appear as a valuable resource facilitating many aspects to remain local, where many activities contribute to keep possible uncertainties and disorders local while allowing for the certain and ordered to travel. This implies that the distributed character of clinical trials, and the activities related to this spatial distribution, participates in producing the certainty and credibility attributed to their results.
Papers for both talks will be circulated ahead of the seminar.