James Lind Library

Ahoy! With the publication of the new SPIRIT guidance on reporting protocols for randomised trials, read about the history of reporting guidelines in the article that Doug Altman and Iveta Simera wrote for me in 2015 www.jameslindlibrary.org/articles/a-h...
#SPIRIT #RCT
@equatornetwork.bsky.social‬

Ahoy! 40 years since #BackToTheFuture, use the James Lind Library to learn about randomised trials through history, including 1985 trial from the #WHO testing coronary heart disease prevention in 50,000 men from 66 factories in Belgium, Italy, Poland & UK
www.jameslindlibrary.org/kornitzer-m-...

INTERNATIONAL PINEAPPLE DAY | June 27 INTERNATIONAL PINEAPPLE DAY June 27 is International Pineapple Day on the National Day Calendar and we want everyone to find a way to enjoy this refreshingly,

On #International#PineappleDay www.nationaldaycalendar.com/internationa... have a look at my record for a @jama.com article from 99 years ago in which George Minot & William Murphy describe a diet (that included #pineapple) for treating pernicious anaemia
www.jameslindlibrary.org/minot-gr-mur...

On #Red4Research Day, visit my website at JamesLindLibrary.org to learn about the development of fair tests of treatment through history

3/3 The article Mike Clarke wrote for me about the series of DICE studies and the importance of Don't Ignore Chance Effects
www.jameslindlibrary.org/articles/the...
#dice #chance

2/3 The need to consider the risk of being misled by the play of chance as a key concept for #InformedHealthChoices
www.jameslindlibrary.org/essays-essay...

and the dangers that a combination of bias and chance will lead to misleading results
www.jameslindlibrary.org/essays-essay...

1/3 On Friday 13th, here's some things you might like to read about the effects of chance in research....
#FridayThe13th #FairTests

Winston Churchill's race to secure penicillin before D-Day found in notes Handwritten notes show the wartime prime minister's frustration over slow penicillin production.

Following the discovery of papers showing Churchill's concerns about the availability of #penicillin during WW2 www.bbc.com/news/article..., read the article Ben Toth wrote for me about some of the research that showed the drug's remarkable benefits www.jameslindlibrary.org/articles/pio... #BBC #WW2

World Bicycle Day | United Nations The bicycle is a simple, affordable, reliable, clean and environmentally fit sustainable means of transportation.

On #WorldBicycleDay (www.un.org/en/observanc...), have a look at this trial from 50 years ago (yes, half a century!) that randomised participants to a control group or 20 weeks of running, walking or cycling for 30 minutes three times a week pubmed.ncbi.nlm.nih.gov/1152627/ #Exercise #RCT

YouTube video by CEBM Oxford Richard Peto - Large-scale randomised evidence: how will it inform clinical practice?

8/8 If you’d like to learn more about the importance of ISIS-2, watch the start of Sir Richard Peto’s talk at Evidence Live 2015 www.youtube.com/watch?v=xYIP... or read what he wrote for me in 2016 www.jameslindlibrary.org/articles/ref... #EvidenceLive #EBHC @cebmoxford.bsky.social

From star signs to trial guidelines The most entertaining example of inappropriate subgroup analysis is to be found in a 1988 Lancet paper.1 Within a complex table reporting subgroup analyses of the odds of vascular death after streptok...

7/8 Analyses, negotiated between authors and editors, include what Richard Horton, @thelancet.com‬ editor, called "the most entertaining example of inappropriate subgroup analysis": no benefit from aspirin for #Gemini & #Libra but clear benefit for other birth signs www.thelancet.com/journals/lan...

6/8 In the 5 weeks after randomisation, there were 804 (9.4%) vascular deaths among 8587 patients allocated aspirin but 1016 (11.8%) in 8600 allocated placebo. The odds of dying in the 5 weeks after their MI were reduced by about a quarter if patients were given 160mg aspirin a day for a month.

5/8 They were randomised to aspirin, streptokinase, both or neither in what’s called a factorial trial, which will feature more in a future #TrialsTuesday. This meant that half the patients got aspirin and half did not.

4/8 More than 400 hospitals across 16 countries took part, recruiting 17,187 patients with a suspected MI between 5 March 1985 and 31 December 1987.

3/8 ISIS-2 was the second International Study of Infarct Survival, and shares its name with that given to the River Thames as it flows through Oxford, where the organisational home of the trial, the Radcliffe Infirmary is based. en.wikipedia.org/wiki/Radclif...

2/8 ISIS-2 is the trial, published in 1988, that showed the life-saving benefits of aspirin for someone having a heart attack, more technically, a myocardial infarction (or MI). www.jameslindlibrary.org/isis-2-secon...

#TrialsTuesday #9 In recent weeks, Trials Tuesday has highlighted some small, practice changing trials. In contrast, today’s trial is one that was described as “massive” by Keith Veronese in Making Medicine. It was called ISIS-2. 1/8

Ahoy! Congratulations to DAMOCLES on its 20th anniversary. Peter Armitage reflected on earlier years of data monitoring committees in his interview with Iain Chalmers: www.jameslindlibrary.org/articles/the...
Another example of seeing the development of fair tests of treatment through history

8/8 Quoting NIHR "The findings of STAMPEDE have led to extended survival rates for men with advanced prostate cancer. They have changed global treatment guidelines and shed new light on long-term outcomes."
www.nihr.ac.uk/about-us/our...

7/8 This was based on the analyses of data for 2962 men randomly assigned to one of four groups, at more than 100 UK and Swiss sites between 5 October 2005 and 31 March 2013. Part of the trial also tested zoledronic acid and found no evidence of survival improvement with that drug.

6/8 Following the #ASCO presentation, the docetaxel finding was published in @thelancet.com‬ in 2016, showing that men allocated to receive this drug and standard care had a median survival of 81 months, compared to 71 months for those allocated to standard care www.thelancet.com/pdfs/journal...

5/8 STAMPEDE started with five comparisons, and eventually had 10 different comparisons by the time it closed on 31 March 2023 after recruiting just 8 short of 12,000 patients with #prostatecancer www.stampedetrial.org

4/8 The design allowed for multiple interventions to be compared simultaneously, with arms being added or dropped as the evidence accumulated.

Multi-Arm Multi-Stage (MAMS) platform trials | MRC Clinical Trials Unit at UCL

3/8 STAMPEDE stands for "Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy" and its design is also an abbreviation: MAMS, meaning multi-arm multi-stage. Today, it might be called a platform trial
www.mrcctu.ucl.ac.uk/our-research...

2/8 Last year, it was recognised as one of the most impactful trials funded by the National Institute for Health and Care Research (NIHR) because of what it has done for the treatment of men with prostate cancer, including that first major result showing the survival benefits for docetaxel

Docetaxel and/or zoledronic acid for hormone-naïve prostate cancer: First overall survival results from STAMPEDE (NCT00268476). 5001 Background: STAMPEDE is a randomised controlled trial using a novel multi-arm multi-stage design. It recruits men (pts) with high-risk locally advanced or metastatic prostate cancer (PCa) start...

#TrialsTuesday #8 1/8 On #InternationalClinicalTrialsDay 2025, we feature STAMPEDE, a trial that started in 2005 and announced its first practice changing results 10 years ago today, to the American Society of Oncology ascopubs.org/doi/10.1200/... @ascocancer.bsky.social‬ @mrcctu.bsky.social‬

Welcome to the James Lind Library, illustrating the development of fair tests of treatments through history.

We have more than 1200 primary historical Records, 280 Articles, and multilingual Essays, along with podcasts, videos and quizzes.

All content is free at www.jameslindlibrary.org

On International Clinical Trials Day, you can learn more about me and what I achieved in the article that was written by Iain Milne www.jameslindlibrary.org/articles/who... #InternationalClinicalTrialsDay #BePartOfResearch

It is not known if van Helmont’s challenge was a rhetorical device, or whether the trial actually took place. However, Iain Donaldson, who wrote an article for me about it in 2016, suggests it was the former. www.jameslindlibrary.org/articles/joa... 8/8

Recognising that a fair test has importance beyond the researchers doing it, the translation goes on to say “let the trial be made for the public good, in order to know the truth, for the sake of your life and soul and for the health of all the people, sons, widows and orphans.” #PPI 7/8