Clinical Equipoise and Adaptive Clinical Trials

Ethically permissible clinical trials must not expose subjects to risks that are unreasonable in relation to anticipated benefits. In the research ethics literature, this moral requirement is typically understood in one of two different ways: (1) as requiring the existence of a state of clinical equipoise, meaning a state of honest, professional disagreement among the community of experts about the preferred treatment; or (2) as requiring an equilibrium between individual and collective ethics. It has been maintained that this second interpretation makes it mandatory to minimize the number of patients receiving the treatment that will eventually be shown to be inferior by the trial. This requirement has led to the development of adaptive trials, i.e., trials in which treatment allocation is determined by data accumulated during interim analysis. Many statisticians argue that in some circumstances—typically with potentially high benefits, as in the much discussed ECMO trial—adaptive design is the only ethically permissible experimental design. Nevertheless, some proponents of clinical equipoise argue that adaptive trials are neither ethically required nor permissible. More specifically, they argue that clinical trials using adaptive designs fail to meet the moral requirement of clinical equipoise, since these trials presuppose an epistemic state that is incompatible with a physician’s duty of care to her subjects. This paper emphasizes that the debate is to a large extent resting on an epistemological confusion. Specifically, I argue that this response conflates two different conceptions of statistical evidence (i.e., frequentist and Bayesian), and that recognizing this distinction elucidates an epistemological framework in which adaptive trials are both consistent with and recommended by the moral requirement of clinical equipoise.

     

L'annee psychologique: history of the founding of a 100-year-old

The authors present the history of the founding of the French journal L'Annee Psychologique. The names of Theodule Ribot (1839-1916), Henry Beaunis (1830-1921), and Alfred Binet (1857-1911) are closely associated with the journal. Ribot's election to the chair of Experimental and Comparative Psychology at the College de France in 1888 marked the official emancipation of psychology in France. Because there was no laboratory associated with the chair, Beaunis, a physiological psychologist from Nancy, proposed to Ribot the creation of the first French laboratory of experimental psychology (1889). Under Beaunis's direction, this laboratory was established at the Sorbonne in Paris but was in fact dependent on another educational institution, L'Ecole Pratique des Hautes Etudes. In 1893 the laboratory's research was first published in a yearly journal named Travaux du Laboratoire de Psychologie Physiologique (2 volumes: 1893-1894). Binet, who joined the laboratory in 1891, was not satisfied by the form of this publication. With Beaunis's agreement, he then created L'Annee Psychologique in 1894 to develop the reputation of the laboratory's research. The authors present the evolution and vicissitudes of the journal from 1895 to 1912, with a glance up to the present.     

Social dominance orientation,prejudice, and discrimination: A new computer-based method for studying discriminatory behaviors

A number of studies have shown that the scale of social dominance orientation (SDO), used to measure the degree of preference for inequality among social groups, is a predictive measure of social and political attitudes toward stigmatized outgroups. However, the relationship between SDO and discrimination has received little attention. The main goal of this study was to assess the validity of a new computer-based method used to measure discriminatory behaviors in a laboratory setting. An additional goal was to test the mediating role of prejudice in the relation between SDO and discrimination. The results provide a first validation of this new method and demonstrate that the effect of SDO on discrimination is mediated by prejudice.     

Another evaluation of touch and helping behavior

Although positive effect of touch on compliance has been widely reported, new evaluation was made with an unusual request. 80 male bus drivers were solicited by a male or a female confederate to take the bus despite having too little money for the fare. Bus drivers were briefly touched by the confederate during solicitation. Analysis showed that bus drivers who were touched accepted the request more favorably but only when made by a female.     

Time-to-contact estimation of accelerated stimuli is based on first-order information

The goal of this study was to test whether 1st-order information, which does not account for acceleration, is used (a) to estimate the time to contact (TTC) of an accelerated stimulus after the occlusion of a final part of its trajectory and (b) to indirectly intercept an accelerated stimulus with a thrown projectile. Both tasks require the production of an action on the basis of predictive information acquired before the arrival of the stimulus at the target and allow the experimenter to make quantitative predictions about the participants' use (or nonuse) of 1st-order information. The results show that participants do not use information about acceleration and that they commit errors that rely quantitatively on 1st-order information even when acceleration is psychophysically detectable. In the indirect interceptive task, action is planned about 200 ms before the initiation of the movement, at which time the 1st-order TTC attains a critical value.     

On discontinuities in motor learning: a longitudinal study of complex skill acquisition on a ski-simulator

The qualitative behavioral reorganizations that occurred during the acquisition of a complex motor skill were examined. Five novice participants practiced for 39 sessions of ten 1-min trials on a modified version of the ski-simulator. Analyses focused on the motion of the apparatus platform, modeled as a self-sustained oscillator. At the beginning of the experiment, all participants adopted a behavior that could be modeled with a highly nonlinear stiffness function and a Rayleigh damping function. The behavior in the final part of the experiment was captured by a qualitatively different model, with a linear stiffness function and a van der Pol damping behavior. The transition from the initial to the final model was gradual and was marked in most cases by an abrupt increase of oscillation frequency. During the transition stage, the 2 damping behaviors seemed alternately exploited within each trial. The results are discussed in the framework of the dynamical systems approach to motor coordination and learning, considering motor skill acquisition as a phase transition.     

Introducing psychology as an academic discipline in France: Théodule Ribot and the Collège de France (1888-1901)

This paper describes the context in which the teaching of psychology as an autonomous discipline was introduced in France, and reproduces the first psychology lecture given in France by Théodule Ribot on 9 April 1888 at The Collège de France. In France, this recognition was delayed because of the negative influence of spiritualist philosophy. It took both the acknowledged status of a man (Ribot) and a minister's decision for this new type of teaching to be accepted in France. After describing the events that took place at the Collège de France and at the Academy of Moral and Political Sciences, we reproduce in full Ribot's inaugural lecture at the Collège, an important document for the history of French psychology. We conclude by describing the circumstances in which this teaching came to its end in 1901.     

How emotional pictures influence visuospatial binding in short-term memory in ageing and Alzheimer’s disease?

The present study examines the prediction that emotion can facilitate short-term memory. Nevertheless, emotion also recruits attention to process information, thereby disrupting short-term memory when tasks involve high attentional resources. In this way, we aimed to determine whether there is a differential influence of emotional information on short-term memory in ageing and Alzheimer's disease (AD). Fourteen patients with mild AD, 14 healthy older participants (NC), and 14 younger adults (YA) performed two tasks. In the first task, involving visual short-term memory, participants were asked to remember a picture among four different pictures (negative or neutral) following a brief delay. The second task, a binding memory task, required the recognition by participants of a picture according to its spatial location. The attentional cost involved was higher than for the first task. The pattern of results showed that visual memory performance was better for negative stimuli than for neutral ones, irrespective of the group. In contrast, binding memory performance was essentially poorer for the location of negative pictures in the NC group, and for the location of both negative and neutral stimuli in the AD group, in comparison to the YA group. Taken together, these results show that emotion has beneficial effects on visual short-term memory in ageing and AD. In contrast, emotion does not improve their performances in the binding condition.     

The influence of suggestibility on memory

We provide a translation of Binet and Henri's pioneering 1894 paper on the influence of suggestibility on memory. Alfred Binet (1857-1911) is famous as the author who created the IQ test that bears his name, but he is almost unknown as the psychological investigator who generated numerous original experiments and fascinating results in the study of memory. His experiments published in 1894 manipulated suggestibility in several ways to determine effects on remembering. Three particular modes of suggestion were employed to induce false recognitions: (1) indirect suggestion by a preconceived idea; (2) direct suggestion; and (3) collective suggestion. In the commentary we suggest that Binet and Henri's (1894) paper written over 115 years ago is still highly relevant even today. In particular, Binet's legacy lives on in modern research on misinformation effects in memory, in studies of conformity, and in experiments on the social contagion of memory.