Randomized Controlled Trials: The “Gold Standard” Between Theory and Practice

Abstract

Randomized controlled clinical trials (RCTs) are the lingua franca of “evidence-based” medicine. They form a universe of knowledge practices with deep social, political, and economic entanglements. STS scholars from a diverse range of fields have detailed some of these entanglements, focusing particularly on RCTs’ epistemic claims and their global infrastructures. The papers in this panel build on these literatures, asking a set of related questions. First, what are the problems that randomized controlled clinical trials purport to solve in psychotherapy research, and what new problems do they introduce? Second, how do researchers and ethics review boards explain the value of using healthy individuals in early-phase clinical trials? Third, how do RCTs spatial configuration shape the distinction between “normal” and “pathological”? To answer these questions, we draw on qualitative and historical data that detail professional contests and debates in the field of psychotherapy, ethical and economic decisions by pharmaceutical companies, and design practices at NIH’s Clinical Center. Together, we examine the politics of knowledge making in medicine and draw out the professional, economic, and social imperatives that shape how RCTs are done and with what consequences for their credibility and that of the knowledge being produced.

Discussant

• Stefan Timmermans

Individual Presentations

• Measuring Success: Debating Psychotherapy’s Value and the Role of RCTs in Assessing It - Mariana Craciun, Tulane University

• Articulating the “Value” of Healthy Volunteers to Drug Development - Jill Fisher, UNC - Chapel Hill

• Race, Space, and Design: RCTs as Concept, Practice, and Material Arrangement - Laura Stark, Vanderbilt University

Session Organizer

• Mariana Craciun, Tulane University