Fee-for-Service Research

To the Editor: Despite an encyclopedic analysis, the Sounding Board article "Fee-for-Service Research" (Jan. 30 issue)* fails to mention a crucial question of drug testing — the comparable-control group. The idea of recruiting randomly selected, seriously ill control patients who will pay extravagant research costs but who will not be treated with the promising but untested drug boggles the mind. Perhaps the new method proposes to go back to clinical impressions of drug effectiveness and safety and to disregard scientifically controlled drug testing. And all this with a separate protocol for each patient. Oh, my. (Dr. Rutstein died on February . . . No extract is available for articles shorter than 400 words.