Clinical Trial History: Clinical Trial Design Across the Ages
The first documented experiment resembling a clinical trial was not conducted by a scientist or doctor, but by a military ruler in the ancient days of the Middle East. His name was King Nebuchadnezzar, and his experiment is recorded in the “Book of Daniel” in The Bible. When Daniel and his friends refused to eat the required meat and wine, Nebuchadnezzar allowed them to have beans and water instead. After 10 days, he assessed their health and when they appeared to be well, he allowed them to continue the separate diet. While this test was not exactly a randomized, double-blinded, placebo-controlled clinical trial, it may very well have been one of the first times in human history that a medical test, however rudimentary, guided a decision about public health.
From those modest beginnings, clinical trials have evolved over the millennia to be more complex and more specific in the goals and outcomes they measure. The design of the studies has developed right alongside. Key events over time are highlighted in the graphic below, from the famous scurvy trial of the 1700s through to the master protocol designs of the current day.