Patient-specific devices and population-level evidence: Evaluating therapeutic interventions with inherent variation

Mary Jean Walker

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Designing and manufacturing medical devices for specific patients is becoming increasingly feasible with developments in 3D printing and 3D imaging software. This raises the question of how patient-specific devices can be evaluated, since our ‘gold standard’ method for evaluation, the randomised controlled trial (RCT), requires that an intervention is standardised across a number of individuals in an experimental group. I distinguish several senses of patient-specific device, and focus the discussion on understanding the problem of variations between instances of an intervention for RCT evaluation. I argue that, despite initial appearances, it is theoretically possible to use RCTs to evaluate some patient-specific medical devices. However, the argument reveals significant difficulties for ensuring the validity of such trials, with implications for how we should think about methods of evidence gathering and regulatory approaches for these technologies.
Original languageEnglish
Pages (from-to)335-345
Number of pages11
JournalMedicine, Health Care and Philosophy
Volume21
Issue number3
DOIs
Publication statusPublished - Sep 2018

Keywords

  • customisation
  • Randomised controlled trial (RCT)

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