There have been several examples of scientists trying to undermine randomized trials— arguing they are not possible, not practical, or not useful.
In 2023 Dr. Vinay Prasad said that scientists who recognized the limitations of randomized-controlled trials (RCTS) were intentionally trying to undermine them. Seeking to spread doubt and mistrust about them, he wrote an article titled The Scientists Who Undermine Randomized Trials that said:
There have been several examples of scientists trying to undermine randomized trials— arguing they are not possible, not practical, or not useful. All of these arguments are false.
Despite not working on any RCTs himself, Dr. Prasad claimed his philosophy was “RCT or STFU for all.” Dr. Prasad also promised that RFK Jr. would be the perfect guy to run RCTs and finally resolve longstanding “questions” on vaccines. In his article Sabotaging RFK Jr’s Confirmation Will Increase Vaccine Hesitancy Dr. Prasad wrote:
The only path to vaccine trust is to create randomized trials and neutral systems and to acknowledge the core concerns about vaccine safety.
Many previous SBM articles have described how these calls for RCTs weren’t made to advance actual research, but rather to spread doubt and mistrust about vaccines and COVID mitigation measures. It’s been a favorite technique of anti-vaxxers for decades.
Randomized trials are not always feasible, possible, or practical.
Now that he is in in power, however, Dr. Prasad has changed his tune rather drastically, using the exact same language he previously lambasted- randomized trials are not always feasible, possible, or practical. Not only is he denigrating RCTs, but this has also become one of his core messages, starting on his first day in office. In just one month, he has done so at least 5 times:
- Randomized controlled trials are not always necessary
- On other issues, we’ve talked about the importance of randomized-controlled trials, and sometimes people say to me “how come you don’t need randomized-controlled trials to take out the petroleum dyes”. And I say, this is just a simple teaching point, the evidence to take a medical product that’s supposed to make you better than to mitigate a potentially harmful substance.
- Randomized trials are not always feasible, possible, or practical.
- Trials vs. real world evidence? The answer to that is both. We will always have a place for controlled clinical studies, but we will also leverage the incredible promise of real-world data.
- In the past, randomized clinical trials were the sole method used to determine if a product was safe and effective. But not all randomized trials are informative—some have poor control groups, unrepresentative populations, or inadequate statistical plans.
It’s quite the journey from “RCT or STFU” to “We will always have a place for controlled clinical studies.”
RFK Jr. Will ‘End The War’ Against Alternative Medicine at the FDA, From Stem Cell Therapy to Chelation
Many people have noticed Dr. Prasad’s drastic medical reversal, now that he and other WWTI doctors have power, and it’s their job to generate gold-standard evidence for the American public. It turns out, these doctors are only capable of making YouTube videos “calling for” others to do RCTs. They are not capable of doing any RCTs themselves.
However, Dr. Prasad’s statements are more than just rank hypocrisy. By repeatedly undermining RCTs- and that’s exactly what he is doing- he is creating a permission structure for the current medical establishment to do whatever they want. They can make drastic changes based on “common sense,” as Dr. Prasad recently put it. While Dr. Prasad demanded the highest standards from his predecessors, he believes the current medical establishment can embrace Feelings-Based Medicine and restrict vaccines on this basis alone. Which RCT shows that it’s wise to limit the COVID vaccine in pregnancy? There’s only “common sense” from sheltered men who have no real-world responsibility for dealing with the consequences.
Dr. Prasad is not the only member of our medical establishment who is undermining RCTs. As Dr. David Gorski discussed Monday they are embracing anecdotal evidence, and recent headlines give a clue as to what sort of “real-world” data RFK Jr. plans to collect and how he plans to use it.
- Kennedy Says ‘Charlatans’ Are No Reason to Block Stem Cells
- RFK Jr. Will ‘End The War’ Against Alternative Medicine at the FDA, From Stem Cell Therapy to Chelation
- Vaccine Opponent Hired by RFK Jr. Scours Official Records for Link to Autism
- RFK Jr. Purges Every Vaccine Adviser on CDC Panel, Will Pick Replacements
What will Dr. Prasad do when RFK Jr. orders him to approves stem cells to help children recover from vaccine-induced autism? Will he resist and tell him “RCT or STFU”? Or will he use his “common sense” and acquiesce to his every demand? We may soon find out.
But no matter what decisions Dr. Prasad makes, we all have the right to reject them unless they are backed by large, rigorous RCTs. RCT or STFU applies to him more than anyone. It’s too bad Dr. Prasad won’t take his own advice.