Drug Trials: Optimum Time of Publication

To the Editor: As a clinician primarily interested in new developments in the therapy for myoclonus that might benefit my patients, I was misled by an initial reading of the Van Woert paper (N Engl J Med 296:70, 1977). The authors use the strength of their biologic and biochemical model to excuse their very inadequate clinical trial. They have reported an unblinded, uncontrolled drug trial on 18 patients, using the same neurologists to assess the improvement in myoclonus as were giving the carbidopa and L-5-hydroxytryptophan. They then point to the effects of these drugs on the urine and cerebrospinal-fluid. . .