An IV study design to estimate an effect size when randomization is not ethical
An investigator I frequently consult with seeks to estimate the effect of a palliative care treatment protocol for patients nearing end-stage disease, compared to a more standard, though potentially overly burdensome, therapeutic approach. Ideally, we would conduct a two-arm randomized clinical trial (RCT) to create comparable groups and obtain an unbiased estimate of the intervention effect. However, in this case, it may be considered unethical to randomize patients to a non-standard protocol.
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