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This chapter presents a 1989 commentary on randomized clinical trials. It argues that given the uncertainties about the wide extrapolation of results after any and all formal clinical studies, it makes sense to consider a graded approach to the release of a promising approach for everyday use. Instead of country-wide release, in a step-wise plan new treatment would be made available in only one city or other specific region in order to closely monitor the initial field experience with unselected patients.
Keywords: medical practice, medical research, randomized clinical trials, graded approach, country-wide release
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