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Correspondence
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Volume 338:841-843 March 19, 1998 Number 12
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Questions about a Placebo-Controlled Trial of Preventive Therapy for Tuberculosis in HIV-Infected Ugandans

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by Angell, M.
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by Whalen, C. C.
To the Editor: The first randomized trial demonstrating the efficacy of isoniazid (as compared with placebo) in preventing tuberculosis in Haitians with human immunodeficiency virus (HIV) infection and positive purified-protein-derivative (PPD) tests was reported by Pape and colleagues in 1993.1 The elegant trial, also placebo-controlled, reported by Whalen et al. (Sept. 18 issue)2 raises an important question: Is there a rationale for conducting additional trials after a positive result?

There seem to be two main methodologic issues that could justify additional placebo-controlled trials: validity, if there were suggestions of systematic biases in the study by Pape et al., and generalizability, . . . [Full Text of this Article]

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