Evidence map›Paper›PMID 24306005›Full record

ReviewNeurology2014

The questionable use of unequal allocation in confirmatory trials.

Spencer Phillips Hey, Jonathan Kimmelman

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Perampanel add-on for drug-resistant focal epilepsy.The Cochrane database of systematic reviews · 2023
    Pooled it
  2. Brivaracetam add-on therapy for drug-resistant epilepsy.The Cochrane database of systematic reviews · 2022
    Pooled it
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  4. Brivaracetam add-on therapy for drug-resistant epilepsy.The Cochrane database of systematic reviews · 2019
    Pooled it
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  7. Economic evaluation of intensive home treatment in comparison to care as usual alongside a randomised controlled trial.The European journal of health economics : HEPAC : health economics in prevention and care · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Spencer Phillips HeyFrom the Studies for Translation, Ethics, and Medicine Group (STREAM), Biomedical Ethics Unit, McGill University, Montreal, Canada.
Jonathan Kimmelman

Funding

Canadian Institutes of Health Research EOG 102824
6 · The paper itself

Abstract

Randomization is the standard means for addressing known and unknown confounders within the patient population in clinical trials. Although random assignment to treatment arms on a 1:1 basis has long been the norm, many 2-armed confirmatory trials now use unequal allocation schemes where the number of patients receiving investigational interventions exceeds those in the comparator arm. In what follows, we offer 3 arguments for why investigators, institutional review boards, and data and safety monitoring boards should exercise caution when planning or reviewing 2-armed confirmatory trials involving unequal allocation ratios. We close by laying out some of the conditions where uneven allocation can be justified ethically.

Indexed as

Random AllocationAnimalsClinical ProtocolsHumansRandomized Controlled Trials as TopicResearch Design

Identifiers

PMID24306005
PMCPMC3873626

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.