The Emergence of the Randomized, Controlled Trial

Abstract

The birth of the randomized, controlled trial (RCT) is typically dated to a 1948 evaluation by the British Medical Research Council (MRC) of streptomycin for the treatment of tuberculosis. But controlled clinical trials and discussions of their designs were increasingly being published in medical journals for at least half a century before the MRC’s report, which was part of a much longer history of efforts to empirically assess experimental therapies. An exploration of this deeper history offers insights into the intellectual and social forces shaping both the advent of and resistance to the controlled clinical trial as a medical research standard and mechanism for taming the therapeutic marketplace.