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Don’t know why you say that making a diagnosis is the most important thing a doctor does. As a general practitioner I hardly ever make a diagnosis. You may be denied insurance, a mortgage, and employment. You are forever labelled. You are a victim. You are not just a person but an asthmatic, a schizophrenic, a leper, an epileptic. Some diseases carry an inescapable stigma, which may create many more problems than the condition itself. Worst of all, the diagnosis of a disease may lead you to regard yourself as forever flawed and incapable of above your problem.

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Almost always patients enter a trial in sequence over a prolonged period. In the simplest procedure, simple randomisation, we determine each patient’s treatment at random independently with no constraints. With equal allocation to two treatment groups this is equivalent to tossing a coin, although in practice coins are rarely used. Instead we use computer generated random numbers. Suitable tables can be found in most statistics textbooks. The table shows an example2: the numbers can be considered as either random digits from 0 to 9 or random integers from 0 to 99.

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