Theory Testing and Implication in Clinical Trials

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conference paper description
John Worrall (2010) and Nancy Cartwright (2011) argue that randomized controlled trials (RCTs) are "testing the wrong theory." RCTs are designed to test inferences about the causal relationships in the study population, but this does not guarantee a justified inference about the causal relationships in the more diverse population in clinical practice. In this essay, I argue that the epistemology of theory testing in trials is more complicated than either Worrall's or Cartwright's accounts suggest. I illustrate this more complex theoretical structure with case-studies in medical theory testing from (1) Alzheimer's research and (2) anti-cancer drugs in personalized medicine.