Representation and Extrapolation: Evidence from Clinical Trials*.
This article examines the consequences and causes of low enrollment of Black patients in clinical trials. We develop a simple model of similarity-based extrapolation that predicts that evidence is more relevant for decision-making by physicians and patients when it is more representative of the grou...
| Publicado en: | Quarterly Journal of Economics Vol. 139; no. 1; pp. 575 - 636 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Feb2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=174684285&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 174684285 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00335533 QJE jtl: Quarterly Journal of Economics issn: 00335533 maglogo: N pubinfo: dt: Feb2024 vid: 139 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 174684285 10.1093/qje/qjad036 ppf: 575 ppct: 61 formats: tig: atl: Representation and Extrapolation: Evidence from Clinical Trials*. aug: au: Alsan, Marcella Durvasula, Maya Gupta, Harsh Schwartzstein, Joshua Williams, Heidi affil: Harvard Kennedy School and National Bureau of Economic Research , United States Stanford University , United States Harvard Business School , United States Stanford University and National Bureau of Economic Research , United States su: Black people Drug efficacy Psychotherapy Extrapolation Perceived benefit Drug prescribing sug: subj: Black people Drug efficacy Psychotherapy Extrapolation Perceived benefit Drug prescribing ab: This article examines the consequences and causes of low enrollment of Black patients in clinical trials. We develop a simple model of similarity-based extrapolation that predicts that evidence is more relevant for decision-making by physicians and patients when it is more representative of the group being treated. This generates the key result that the perceived benefit of a medicine for a group depends not only on the average benefit from a trial but also on the share of patients from that group who were enrolled in the trial. In survey experiments, we find that physicians who care for Black patients are more willing to prescribe drugs tested in representative samples, an effect substantial enough to close observed gaps in the prescribing rates of new medicines. Black patients update more on drug efficacy when the sample that the drug is tested on is more representative, reducing Black-white patient gaps in beliefs about whether the drug will work as described. Despite these benefits of representative data, our framework and evidence suggest that those who have benefited more from past medical breakthroughs are less costly to enroll in the present, leading to persistence in who is represented in the evidence base. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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