Dr Allan Gaw MICR, SA Press (2009), 88pp, £9.99, ISBN13: 978-0-9563242-0-7
Book review by Andrew Smith
Keywords
Book review, History, Publication, Research ethics, Research methodology
The rationale for this excellent little book is summed up by Mark Twain, quoted in the introduction: “The past does not repeat itself, but it rhymes.” Learning about the history of clinical trials helps us to understand why the present is the way it is, and provides insights into ways of thinking and working that many of us would otherwise simply take as given. The author is Director of Operations at the Glasgow Clinical Research Facility, and this book presents some of the key historical anecdotes used in his training courses there.
Starting in the 7th century BC, Allan uses ancient Egypt and Babylon to introduce the use of scientific method and the importance of publication, demonstrates that Cleopatra was a far more diligent scientist (albeit with no qualms about killing her subjects) than Elizabeth Taylor’s on-screen portrayal would have us believe, and traces randomisation and care to avoid bias back to 16th century Flanders. Moving to pre-Revolutionary France, he explains the roots of blinding and placebo control with a cast of characters including Benjamin Franklin and Franz Mesmer (who first ‘mesmerised’ people!) At the end of each chapter, a conclusion highlights precisely how the incidents of the past are linked to the practices of the present and why these events were important for how we work today.
For me, the final two chapters are perhaps the least interesting, because they discuss two ‘old chestnuts’ that are at the heart of almost all lectures on research ethics: the Tuskegee syphilis study and the Nazi trials leading to the development of the Nuremburg Code. Even these topics, though, are considered in more detail than in many lectures, and I certainly learned new details and gained new insights.
If there is a notable absence, it is the story of James Lind, whose six-armed study into treatment of scurvy in 1747 is commemorated by ECRIN’s International Clinical Trials Day each May 20th. While several of the experiments that are discussed predate key elements of Lind’s study, these were elucidated by modern archaeology and research and were probably unknown to Lind. It is one of the most famous early clinical trials, and perhaps could have been acknowledged, even if no further lessons could be drawn from it.
The book is well put together, with plenty of references for each chapter plus a glossary, a selection of useful websites (although with no mention of ICR!) and suggestions of further reading. It is written in a clear, readable style, with interpretation as well as factual account, highlighting the aspects of each topic that have had the most significant impact on the way clinical research is done today.
Who would benefit from reading this book? Certainly, students or anyone moving into a career in clinical research would find it an excellent introduction to why we do things in the way that we do. For the rest of us, its brevity and tone make it a nice read for a train journey or a quiet evening, providing some new anecdotes and insights into some of the less familiar, but nonetheless important, steps in the development of clinical research.
Andrew Smith is Editor of Clinical Research focus.
