<International Circulation>: Is there an ethical problem with randomizing patients to those arms with lesser therapies in that kind of trial?
Prof. Lutsep: There is still enough of a question without a randomized trial that you can argue that you could still do that. However， it is a real dilemma. Frequently， patients are transferred from far away to our hospital and it is hard to tell them that they are going to receive a lesser treatment.
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