So, if we restrict ourselves to "drugs taken by healthy people, out of fear of future disease", then we are in the domain of gambling - ie playing the odds.
From the point of view of any individual person making a decision as to whether to take this punt, the sole value of an RCT is to provide the same benefit that a bookmaker provides to their punters, giving a fair assessment of odds. The punter then decides whether those odds stack up, for them. With no guarantee of success... it's gambling, after all! Odds are odds, not certainties.
The only thing that I would add to this, though, is that the standard of safety that should apply to drugs taken by healthy people, out of fear of future disease, is of the very highest and most rigourous. There should be a near zero chance of that drug taking away ANY of the health the person already enjoys, otherwise the uncertain prospect of not getting a feared disease that might never happen anyway, is a bet worth forgoing.
Re: 24-5 flu vaccine study
So, if we restrict ourselves to "drugs taken by healthy people, out of fear of future disease", then we are in the domain of gambling - ie playing the odds.
From the point of view of any individual person making a decision as to whether to take this punt, the sole value of an RCT is to provide the same benefit that a bookmaker provides to their punters, giving a fair assessment of odds. The punter then decides whether those odds stack up, for them. With no guarantee of success... it's gambling, after all! Odds are odds, not certainties.
The only thing that I would add to this, though, is that the standard of safety that should apply to drugs taken by healthy people, out of fear of future disease, is of the very highest and most rigourous. There should be a near zero chance of that drug taking away ANY of the health the person already enjoys, otherwise the uncertain prospect of not getting a feared disease that might never happen anyway, is a bet worth forgoing.