Healthy Skepticism Library item: 5403

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Orlowski JP, Christensen JA.
The potentially coercive nature of some clinical research trial acronyms.
Chest 2002 Jun 01; 121:(6):2023-8
http://www.chestjournal.org/cgi/content/full/121/6/2023

Abstract:

STUDY OBJECTIVES: To evaluate the potential coerciveness of clinical research trial (CRT) acronyms, and to make clinicians aware that some CRT acronyms may be coercive to research subjects by subliminally enticing or outwardly promising something that the CRT may not be able to deliver. DESIGN: Analysis of CRT acronyms for pleasantness and meaningfulness as assessed by studies in the behavioral and social psychology literature. RESULTS: Of 2,383 acronyms for CRTs analyzed, 155 acronyms (6.5%) were assessed as possibly, probably, or almost certainly coercive. On a Likert scale from 1 to 5 for pleasantness or meaningfulness, the acronyms identified as almost certainly coercive had a mean pleasantness score of 4.21 (range, 3.70 to 4.57), the acronyms identified as probably coercive had a mean score of 3.79 (range, 2.45 to 5.00), and the acronyms identified as possibly coercive had a mean score of 3.89 (range, 2.81 to 5.00). CONCLUSIONS: A distraught or frightened patient with a life-threatening illness who is offered a research study with an acronym of CURE, HOPE, HELP, IMPROVED, LIFE, RESCUE, MIRACL (sic), SAVED, or ALIVE is possibly being coerced by the acronym. Institutional review boards (IRBs) and the medical research community would not tolerate a CRT entitled, “A Surefire Cure for Cancer.” They should be no more tolerant of a CRT with an acronym listed above. It is time for researchers, sponsors, and IRBs to take a more responsible approach to potentially coercive CRT acronyms and discourage or prohibit their use.

Keywords:
Clinical Trials/standards* Coercion* Humans Terminology*

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909