DOUBLE-BLIND CLINICAL-TRIALS IN SEPSIS RESEARCH - PROBLEMS CONNECTED WITH PHYSICIANS AND PATIENTS EXPECTANCIES - DISCUSSION

The argument is brought forth that double-blinding in the strict sense , i.e. the elimination of differential expectations concerning treatme nt effectiveness, can hardly be achieved in sepsis trials because of t he complexity of the clinical problem and of available treatment regim ens. Recommendations for an improved study design include assessments of doctors' expectancies concerning treatment outcome, or the experime ntal induction of optimistic expectations vs. neutral expectations. Ho wever, in planning and conducting such an experimental expectancy-cont rol design, a number of ethical requirements have to be considered and met.