Adam Kucharski

So a lot of the kind of superstition, this idea that disease or conditions just kind of come out of nowhere and it's bad people or someone's a witch or this kind of stuff that was going around in much of Europe at the time.

There was a lot of early writings even around sort of the 11th century saying these aren't supernatural.

There's natural causes and we can study them.

Yeah, we can study them.

We can work out what the cause of effects were.

A lot of early attempts to try and think about concepts that we would now call things like having a control group or thinking about how we kind of would divide and treat some people and not treat some people and then compare the difference.

The conclusions didn't always work.

work out.

I mean, there was, I think one of the earlier studies was someone who'd identified correctly the symptoms of meningitis, but then concluded that bloodletting was really effective for it, which probably something in their study design had gone astray.

But again, it just kind of really, and it's one of the things you look back on and you think it's just, it's pretty obvious that we should be doing it that way.

But even coming into the 20th century, if you look at something like analysing a medical treatment, a lot of the early studies

did an alternation method.

Because if you think about it, rather than randomize patients, you could just say, well, the first patient that comes in, I'm going to treat, the second I won't, the third I will, fourth I won't.

And on average, you should get something that any other sources of variability should balance out and the difference in those groups should be on average down to the treatment effect.

But Bradford Hill, actually, who did a lot of the pioneering work in the early sort of clinical trial space, noticed that the groups were often imbalanced.

Because what was happening is patients were coming in and doctors were maybe subconsciously, oh, maybe that person looks a bit ill.

I'll enroll them.

Or maybe they don't meet the diagnosis.

And actually, a lot of the early randomization wasn't statistical.

It was just to sort of keep humans from themselves because we couldn't trust subconscious judgment.