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Correspondence |

IDEAL for CCSVI Research—Reply

Michael A. Williams, MD; Arun Venkatesan, MD, PhD
Arch Neurol. 2012;69(7):939-940. doi:10.1001/archneurol.2012.325.
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We thank Dr Reekers for his comments. We recognize and respect that differing views regarding the ethical permissibility of clinical research in CCSVI exist. As we stated, a strong scientific case has been made against CCSVI as a causative factor in multiple sclerosis, and we shared our doubt regarding its validity. Nonetheless, published clinical research suggests that endovascular intervention may be effective in at least a portion of involved patients. Therefore, we argue that a vital prerequisite for research to be conducted (ie, equipoise) exists. Equipoise in this instance is not an individual's sense of ambivalence regarding the efficacy of a novel treatment, but rather the existence of uncertainty within the scientific community regarding its efficacy compared with existing therapies or placebo.

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July 1, 2012
Jim A. Reekers, MD, PhD, EBIR
Arch Neurol. 2012;69(7):939-940. doi:10.1001/archneurol.2012.322.
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