Reconsideration of Methodology in Studies of Pain Relief

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Abstract
When comparing drugs used for the relief of pain, the standard practice is to arrange the experiment so that "each patient acts as his own control." The basis for this practice is the belief that discrimination between drugs will be more precise if they are tested on the same patient than if they are tested on different patients. In a comparison of 3 drugs used for relief of post-operative pain (10 mg Demerol and 2 levels of an exploratory drug) it was found that due the marked reduction in pain with time after operation the "within patient" comparisons were quite variable, and a design using only one drug for each patient would have permitted better discrimination between the drugs. It is suggested that in studies of pain relief the advantage of the "own control" designs may be less universal than has been thought.