In a second example, the CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) CTs tested the effects of antipsychotic medications on schizophrenia but may have failed to yield clinically useful results because insufficient preparations necessitated that ad hoc assumptions be made to apply the trial outcomes in patient care (Fig. 2). The problems with this trial do not obviously conflict with good laboratory practices as described (13). Over the last half century, the results of commercially sponsored studies had shown that many different antipsychotic drugs were more effective than placebo treatments, but no direct drug-to-drug comparisons had been done. Exposed to heavy advertising by drug manufacturers, doctors developed preferences for a second generation of antipsychotics. In a much-needed test of these preferences, the U.S. National Institutes of Health sponsored the CATIE studies (49). Except for side-effect profiles that were useful to practitioners, these CATIE studies failed to confirm that the first- and second-generation antipsychotics differed in efficacy (50, 51).
