The Sociology of Medical Evaluation: Case Studies

Abstract

In a previous paper we explained the socio-economic context in which
clinical trials are implemented and evaluated, and in which their results
are published, whilst showing some of their methodological limitations. In
this study, after showing two different models of evaluation (methodological
and cognitive), we analyse the controversial evaluation of three drugs:
two of them having been evaluated by clinical trial and the third one not,
in spite of the willingness of the drug manufacturer to undertake this type
of evaluation. As a result of this research, further fi ndings were made with
regard to the considerable infl uence that the socio-economic component
of clinical trial evaluation has, as opposed to that of the technical, on
deciding whether a new drug should or should not pass the evaluation,
even though it is the technical/scientifi c component that is supposed to
prevail. From a methodological perspective, this conclusion leads to
question the methodological model of evaluation, and to think, however
tentatively, of an alternative, namely, the cognitive model of evaluation.