The Medical Research Council and clinical trial methodologies before the 1940s: the failure to develop a ‘scientific’ approach

Abstract

2007 monograph, Martin Edwards wrote that Fletcher 'repeatedly affirmed his conviction that medicine and therapeutics could only progress through fundamental scientific research, frequently performed by non-clinical scientists rather than clinicians'. 8,9 Edwards noted that this trend was reinforced in 1920 when the Medical Research Committee was separated from the Ministry of Health, and became the Medical Research Council, which was responsible to the Privy Council. The way in which the new Council distinguished itself from the Ministry of Health was through its laboratory-based research, with the National Institute of Medical Research at the centre of its operations. The two bodies reached an agreement in 1924: the Ministry of Health was to be concerned with 'applied research' relating to clinical problems; the MRC would initiate and organize all new research in the basic biomedical sciences. Fletcher argued that 'progress in physiology, biochemistry, and pathology was essential to the development of clinical practice'. 8,9

The Medical Research Council and treatments for tuberculosis before streptomycin

“…Although small grants were given to individuals and institutions to assess methods of treating tuberculosis, these assessments were not conducted in any systematic way, a record of failure comparable to that of the Council's Therapeutic Trials Committee. 36 Although no well-designed prospective trials had been conducted within the field of tuberculosis, debate about research methods began in the late 1930s, with Bradford Hill intent on defending the statistical method, even if it had been unsuccessfully applied by the Council up to that time.…”

UK Medical Research Council and multicentre clinical trials: from a damning report to international recognition

“…24 Nevertheless, the lessons learned from this imperfectly conducted trial did pave the way for the methodologically robust trials that were to become a hallmark of the MRC's work in the 1940s and 1950s.…”

The advent of fair treatment allocation schedules in clinical trials during the 19th and early 20th centuries

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