Information about Testing Treatments Two

The story of Testing Treatments
Since Testing Treatments was published by the British Library in 2006 we have often been asked how we came to write our book. The tale began when Imogen Evans, a medical doctor, was commissioned by the British Library to write a book for the public on a topic of her choice. She chose a subject that had interested and vexed her for years in equal measure: how to ensure that research into medical treatments best meets the needs of patients. She was delighted when two colleagues - Iain Chalmers, a healthcare researcher, and Hazel Thornton, an independent lay advocate for quality in research - agreed to join her as co-authors.

Our guiding principle was to promote more critical public assessment of the effects of treatments by encouraging patient-professional dialogues. We wanted to share our enthusiasm for the topic by writing an honest book that did not preach to readers. Researching our source material re-emphasised to us the importance of reliable evidence about treatment effects and the dangers of relying on recollections – our memories were sometimes faulty too. Along the way we were greatly encouraged by the reactions of colleagues and friends, who gave their time generously, tracked down material, caused us to think and re-think many times over, and read and commented on drafts of the book.

Testing Treatments Two
From the outset, we thought of Testing Treatments as ‘work in progress’. There will almost always be uncertainties surrounding the effects of treatments, both new and old, so there is a constant need to ensure that all treatments are tested properly; and to visit and re-visit the evidence. Since we made Testing Treatments freely available on-line on The James Lind Library website, we have been truly heartened by the level of interest shown in the book. Now we are planning for Testing Treatments Two to be published in 2011, also to be freely available on the web.  And we are thrilled that Margaret McCartney, a general practitioner and medical writer, has joined the team as a co-author for Testing Treatments Two (see About the Authors for our biographical details).

We are gathering information for use in Testing Treatments Two. We would be pleased to be directed towards papers thought important by readers; please send suggestions to testingtreatments@jameslindlibrary.org. We will add other topics to this list over time.

Potential new treatments: first tests in people
In March 2006, six people taking part in a voluntary test of an anti-inflammatory drug in a commercial clinical trials unit in Northwick Park, London, became seriously unwell and were admitted to intensive care. This was reported internationally and has been the focus of much concern from government, citizens, patients, and scientists, In Testing Treatments Two we want to address the important issues surrounding the testing of potential treatments for the first time in people. Is absolute safety ever possible? Should such testing be done more stringently? How should results of preliminary laboratory and animal studies be collated and analysed before moving forward to tests in people?

Placebo (psychologically mediated) effects: important in good healthcare
Placebo effects are often considered a nuisance when it comes to assessing treatments in clinical trials. However, these psychologically mediated effects are often an integral part of healthcare and can help to improve its effectiveness. The ways that healthcare providers work – for example, by providing continuity of care, or by having a good relationship with their patients – can have beneficial effects on health. We want to examine how these kinds of psychologically mediated effects work best in healthcare.

Complementary and alternative medicines: fair tests for all
In Testing Treatments Two we are keen to include more about these kinds of treatments. However, we want to deal with these in the main body of the book rather than in a separate section. This is because we think fair tests should apply to all treatments, no matter what their origin or how they may be categorised. We would be pleased to be directed towards examples of fair tests of complementary or alternative interventions known to you, particularly good systematic reviews of rigorous controlled trials.

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