First randomized controlled trial

The first published randomized controlled trial (RCT) was “Streptomycin treatment of pulmonary tuberculosis,” authored by a team of researchers associated with the British Medical Research Council. It was published in the 30 October 1948 edition of the British Medical Journal.

This trial was organized by the Medical Research Council (MRC) in the UK, with Austin Bradford Hill playing a pivotal role in its design. Hill’s method introduced the concept of randomization to ensure unbiased allocation of participants to treatment and control groups, which laid the foundation for modern clinical trials.

While RCTs in medicine became prominent in the mid-20th century, the concept of randomized experiments traces back earlier to other fields. In the late 19th century, Charles Sanders Peirce and Joseph Jastrow introduced randomized experiments in psychology, and randomized trials in agriculture were conducted by Ronald A Fisher and Jerzy Neyman in the early 20th century. However, the 1948 study is recognized as the first clinical trial to adopt this methodology fully in medicine, shaping the future of evidence-based practice in healthcare.