The misguided ethics of crossover trials

Vinay Prasad, Christine Grady

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Crossover is increasingly favored in trials of cancer therapies; even those that seek to establish the basic efficacy of novel drugs. Crossover is done in part for trial recruitment, but also out of a sense of doing the right thing-offering the investigational agent to more patients. In this paper, we argue that this ethical inclination-that crossover is a preferred trial choice-is misguided. In seeking to sate the desires of participants, we might undermine a trial's ability to answer a meaningful clinical question. When a trial is incapable of answering a question, it becomes unethical. Using a crossover strategy in oncology clinical trials can make trials less ethical, not more.

Original languageEnglish (US)
Pages (from-to)167-169
Number of pages3
JournalContemporary Clinical Trials
Issue number2
StatePublished - Mar 2014


  • Crossover
  • Ethics of clinical trials
  • Trial validity

ASJC Scopus subject areas

  • Pharmacology (medical)


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