Comparing drug effectiveness at health plans: The ethics of cluster randomized trials
"Cluster randomized trials," in which groups of patients are randomly assigned to different therapeutic interventions, provide a powerful way of evaluating drugs. CRTs have not been widely used, in good part because of concerns about whether patients must give informed consent to participate in them. A better understanding of how CRTs fit into clinical practice resolves the concerns.
Sabin JE, Mazor K, Meterko V, Goff SL, Platt R. Comparing drug effectiveness at health plans: The ethics of cluster randomized trials Hastings Cent Rep 2008 Sep;38(5):39-48.