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August 2014
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How much do you know about fair tests of treatments?
These questions test your knowledge of why it’s important to carry out fair tests of treatments – medical, surgical, complementary or any other kind – before routinely using them in practice.
Are you a good bullshit detector?
Click “start quiz” to find out!
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Question 1 of 17
1. Question
What is the likelihood, on average, of a new treatment being better than an existing, standard treatment?
Correct
Have a look at the largest study addressing the question ‘How often, on average, does a new treatment turn out to be better than and existing treatment?’
Incorrect
Have a look at the largest study addressing the question ‘How often, on average, does a new treatment turn out to be better than and existing treatment?’
Hint
If you would like to read relevant material before answering, refer to Djulbegovic B, Kumar A et al. Trial unpredictability yields predictable therapy gains. Nature 2013:500;395-396.
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Question 2 of 17
2. Question
How often do doctors do more good than harm?
Click the answer that you think comes closest
Correct
This section describes several examples where doctors have got it wrong, but we don’t know exactly how often it happens.
Incorrect
This section describes several examples where doctors have got it wrong, but we don’t know exactly how often it happens.
Hint
Can you think of any examples of treatments that turned out to do more harm than good?
You can find out more about this in “New – but is it better?” or download a PDF. -
Question 3 of 17
3. Question
Does belief in the effects of a treatment influence the likelihood that those effects will be experienced?
Click any that are true
Correct
In addition to this video by Ben Goldacre, you may like to watch this video on the research done by American schoolgirl Emily Rosa and you might like to read more about fair measurement of treatment outcomes.
Incorrect
You may like to watch this video by schoolgirl Emily Rosa and you might like to read more about fair measurement of treatment outcomes.
Hint
Have you ever felt better after visiting a kind doctor, even though you haven’t started taking the medicine he or she prescribed for you? You might like to watch this video by Ben Goldacre discussing placebo effects.
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Question 4 of 17
4. Question
In a study to assess the effects of a new antiviral agent for flu-like illness, 100 people were given the new drug.
One week later the researchers observed that 90 of the 100 people were better.
What were the researchers justified in concluding?
Tick any justified conclusions
Correct
From this study, we don’t know whether they would have got better even without the treatment. Hence a “fair test” generally needs a comparison, or “control”, group of patients. Read more about “Nature – the Healer“.
Incorrect
From this study, we don’t know whether they would have got better even without the treatment. Hence a “fair test” generally needs a comparison, or “control”, group of patients. Read more about “Nature – the Healer“.
Hint
Consider what would happen if the 100 people had had no treatment.
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Question 5 of 17
5. Question
In a fair comparison of two treatments, patients are allocated at random so that:
(Tick any that are true)
Correct
Watch this video or read more in Testing Treatments interactive.
For more detail, read Odgaard-Jensen et al, Randomisation to protect against selection bias in healthcare trials. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No.: MR000012. DOI: 10.1002/14651858.MR000012.pub3.
Incorrect
Watch this video or read more in Testing Treatments interactive.
For more detail, read Odgaard-Jensen et al, Randomisation to protect against selection bias in healthcare trials. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No.: MR000012. DOI: 10.1002/14651858.MR000012.pub3.
Hint
When testing comparing treatments, its important to ensure that patients in the comparison groups are alike except in respect of the two treatments being compaed. You might like to either watch this video or read more in Testing Treatments interactive.
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Question 6 of 17
6. Question
Placebos are useful in clinical trials:
(Tick any that are true)
Hint
Seeing can lead to believing; but believing can also lead to seeing. Consider Point 3 in this video.
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Question 7 of 17
7. Question
In a small randomized double-blind trial of a new treatment for heart attacks, the number of patients receiving the new treatment who died was half the number who died in the comparison group, but the difference was not statistically significant.
Tick any that are true
Hint
Have you heard of ‘the law of large numbers’? You can find out more about it in Taking account of the play of chance.
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Question 8 of 17
8. Question
Study results are often given together with “confidence intervals”, for example, that 40% ± 5% of people (i.e. a confidence interval from 35% to 45%) suffer depression after experiencing a stroke.
Which of the following statements about a confidence interval is correct?
Tick any that are true
Hint
It’s important to assess the role that chance may have played in fair tests of treatment. See Taking account of the play of chance.
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Question 9 of 17
9. Question
A “systematic review” of the reports of clinical trials is a synthesis of research addressing a specific question. Such systematic reviews have the following features:
Tick any that are true:
Hint
By cherry picking the results of some studies it is possible to prove almost anything.
Have a look at this video about fad diets.
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Question 10 of 17
10. Question
When you are checking whether a review of research on a specific treatment is trustworthy, which questions should you ask?
Tick any that are true
Hint
Consider the message in this cartoon.
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Question 11 of 17
11. Question
What should you believe when some fair tests of a treatment suggest one thing about its effects and other fair tests suggest different effects?
Tick all that are true
Hint
Is it ever right to base your conclusions about the effects of a treatment on a single, or even several studies when many have been done?
If you would like to read relevant material before answering, read more about systematic reviews of all the relevant, reliable evidence.
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Question 12 of 17
12. Question
When people receive a treatment as part of a research project, do they run a greater or a lower risk compared with others who receive the same treatment outside research?
Tick any that are true
Correct
There is good evidence to indicate that participation in randomized controlled trials (RCTs) is associated with similar outcomes to receiving the same treatment outside RCTs.
For more detail, see Vist GE, Bryant D et al. Outcomes of patients who participate in randomized controlled trials compared to similar patients receiving similar interventions who do not participate. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: MR000009. DOI: 10.1002/14651858.MR000009.pub4.
Incorrect
There is good evidence to indicate that participation in randomized controlled trials (RCTs) is associated with similar outcomes to receiving the same treatment outside RCTs.
For more detail, see Vist GE, Bryant D et al. Outcomes of patients who participate in randomized controlled trials compared to similar patients receiving similar interventions who do not participate. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: MR000009. DOI: 10.1002/14651858.MR000009.pub4.
Hint
Research on the effects of treatments is only justified if it addresses important uncertainties.
If you would like to read relevant material before answering, consult: Vist GE, Bryant D et al. Outcomes of patients who participate in randomized controlled trials compared to similar patients receiving similar interventions who do not participate. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: MR000009. DOI: 10.1002/14651858.MR000009.pub4.
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Question 13 of 17
13. Question
In a placebo-controlled trial of new drug, Kuritol, 8% of those allocated to Kuritol died compared to 12% allocated to the placebo.
What percent of people given placebo survived?
Click the correct answer
Correct
100 minus 12 equals 88!
Incorrect
100 minus 12 equals 88!
Hint
If ‘only’ 12% of people allocated to placebo died, most must have survived.
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Question 14 of 17
14. Question
In a placebo-controlled trial of new drug, Kuritol, 8% of those allocated to Kuritol died compared to 12% allocated to the placebo.
There are different ways to compare the survival in the two groups. Can you work out which is correct?
The difference in the likelihood of death for patients given Kuritol is:
Correct
12 percent minus 8 percent equals 4 percent.
Incorrect
12 percent minus 8 percent equals 4 percent.
Hint
What is the difference between the two percentages of patients who died?
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Question 15 of 17
15. Question
In a placebo-controlled trial of new drug, Kuritol, 8% of those allocated to Kuritol died compared to 12% allocated to the placebo.
The relative reduction in the likelihood of death with Kuritol is:
Correct
12 percent minus 8 percent equals 4 percent, and 4 is one third (33 percent) of 12.
Incorrect
12 percent minus 8 percent equals 4 percent, and 4 is one third (33 percent) of 12.
Hint
Express the reduction (4 percent) as a proportion of the death rate without Kuritol.
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Question 16 of 17
16. Question
In a placebo-controlled trial of new drug, Kuritol, 8% of those allocated to Kuritol died compared to 12% allocated to the placebo.
How many similar patients need to be treated with Kuritol to prevent one of them dying?
Correct
The (12%-8%) 4% reduction in the risk of death means that 4 deaths will be prevented for every 100 patients treated with Kuritol. Therefore, 1 death will be prevented for every 25 patients treated with Kuritol.
Incorrect
The (12%-8%) 4% reduction in the risk of death means that 4 deaths will be prevented for every 100 patients treated with Kuritol. Therefore, 1 death will be prevented for every 25 patients treated with Kuritol.
Hint
Death was prevented in 4 out of 100 patients treated with Kuritol.
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Question 17 of 17
17. Question
If you’re invited to participate in research to test treatments, which of these conditions should you insist be met before you decide whether or not to participate?
Tick any that are true
Hint
If you would like to read relevant material before answering, have a look at the Testing Treatments Action Plan.
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