SynthesisBMJ (Clinical research ed.)2005
Are experimental treatments for cancer in children superior to established treatments? Observational study of randomised controlled trials by the Children's Oncology Group.
Synthesis in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Risk-Benefit of Phase 2 Monotherapy Trials in Adult Solid Cancers: A Systematic Review and Meta-Analysis.International journal of cancer · 2026Pooled it
- Treatment success in cancer: industry compared to publicly sponsored randomized controlled trials.PloS one · 2013Pooled it
- Optimism bias leads to inconclusive results-an empirical study.Journal of clinical epidemiology · 2011Pooled it
- Trial
- Implications of the Cass Review for health policy governing gender medicine for Australian minors.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2025Review
- Identification of threshold for large (dramatic) effects that would obviate randomized trials is not possible.Journal of clinical epidemiology · 2022Article
- Article
- Observational
- The Rise of Consumer Health Wearables: Promises and Barriers.PLoS medicine · 2016Review
- Article
- Randomized controlled trials in environmental health research: unethical or underutilized?PLoS medicine · 2015Article
- Attitudes Toward Cancer Clinical Trial Participation in Young Adults with a History of Cancer and a Healthy College Student Sample: A Preliminary Investigation.Journal of adolescent and young adult oncology · 2014Article
- Tackling treatment uncertainties together: the evolution of the James Lind Initiative, 2003-2013.Journal of the Royal Society of Medicine · 2013Article
- New treatments compared to established treatments in randomized trials.The Cochrane database of systematic reviews · 2012Article
- Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences.BMC medical ethics · 2011Article
- Review
- Predicting harms and benefits in translational trials: ethics, evidence, and uncertainty.PLoS medicine · 2011Article
- The paradox of equipoise: the principle that drives and limits therapeutic discoveries in clinical research.Cancer control : journal of the Moffitt Cancer Center · 2009Article
- Childhood and adolescent cancer survival in the US by race and ethnicity for the diagnostic period 1975-1999.Cancer · 2008Article
- Speeding up the evaluation of new agents in cancer.Journal of the National Cancer Institute · 2008Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesTo assess how often new treatments for childhood cancer assessed in phase III randomised trials are superior or inferior to standard treatments and whether the pattern of successes and failures in new treatments is consistent with uncertainty being the ethical basis for enrolling patients in such trials.
designObservational study.
settingPhase III randomised controlled trials carried out under the aegis of the Children's Oncology Group between 1955 and 1997, regardless of whether they were published.
main outcome measuresOverall survival, event free survival, and treatment related mortality.
results126 trials were included, involving 152 comparisons and 36,567 patients. The odds ratio for overall survival with experimental treatments was 0.96 (99% confidence interval 0.89 to 1.03), indicating that new treatments are as likely to be inferior as they are to be superior to standard treatments. This result was not affected by publication bias, methodological quality, treatment type, disease, or comparator.
conclusionsNew treatments in childhood cancer tested in randomised controlled trials are, on average, as likely to be inferior as they are to be superior to standard treatments, confirming that the uncertainty principle has been operating.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.