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General medicine
Is clinical effectiveness in the eye of the beholder during the COVID-19 pandemic?
  1. José Luis Sandoval,
  2. Alex Friedlaender,
  3. Alfredo Addeo
  1. Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to Dr José Luis Sandoval, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland; jose.sandoval{at}; Dr Alfredo Addeo; alfredo.addeo{at}

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There is no shortage of clichés being used during the current global pandemic, but none is more striking than the Hippocratic aphorism ‘for extreme diseases, extreme methods of cure’ or, in its modern variants, ‘for desperate times, desperate measures’ or even, ‘take it! What do you have to lose?’.

The current crisis has challenged the erroneous perception that threats to global public health by rapidly spreading infectious diseases were under control. COVID-19 is indeed an extreme disease, not in its nature but due to its global reach and the level of social disruption it is causing. The extent of the direct and indirect adverse effects of the COVID-19 pandemic on the global socioeconomic structures is yet to be ascertained but will probably have systemic and long-lasting repercussions.

In these challenging times, we must consider drastic measures to ensure that clinical practice continues to be rooted in sound evidence. Contrary to those fighting to control the 1918 influenza pandemic, we have at our disposal a body of methodological knowledge to conduct rapid and efficient clinical trials. Furthermore, innovations in information technology, computing and telecommunications have made economic globalisation a reality and enabled a previously unimaginable level of global interconnectedness. As with other sectors of society, science and medicine have significantly benefited from the almost instantaneous speed of communication between different parties involved in medical research, fostering collaboration and information dissemination.

It is thus essential, at a time when global public …

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  • Contributors All authors have contributed to drafting the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AA has received compensation from Bristol-Myers Squibb, AstraZeneca, Merck Sharpe & Dohme, Takeda, Pfizer, Roche and Boehringer Ingelheim for participating on advisory boards. AF has received compensation from Roche, Pfizer, Astellas and Bristol-Myers Squibb for service as a consultant.

  • Provenance and peer review Not commissioned; externally peer reviewed.