What the study found
The authors found little evidence of chronic contestation of medical knowledge-claims in the rivaroxaban controversy. Instead, they argue that a process of closure through synthetic certainization helped establish claims that rivaroxaban was efficacious and cost-effective.
Why the authors say this matters
The authors conclude that synthetic certainization, together with a regulatory ideological commitment to innovation, curtailed contestation and discouraged the medical profession from facing troubling uncertainties. They present this as relevant to understanding how medical and regulatory power shaped the controversy.
What the researchers tested
This research article examines the controversy around rivaroxaban for stroke prevention in patients with non-valvular atrial fibrillation in England, following the discovery that the INRatio2-PT medical device used to monitor coagulation and generate crucial trial data was defective. The authors draw on social science theories of medical controversies and use documentary and interview data to explore the roles of key protagonists.
What worked and what didn't
The findings about the media partly support countervailing powers theory. Findings about industry and regulators support corporate bias theory. The authors report little evidence for chronic contestation of medical knowledge-claims, and instead describe closure through synthetic certainization.
What to keep in mind
The abstract does not provide quantitative results or detailed methods beyond documentary and interview data. The account is limited to the INRatio2-PT/rivaroxaban controversy and to the authors' theoretical interpretation of that case.
Key points
- The authors found little evidence of chronic contestation in the rivaroxaban controversy.
- They argue that closure through synthetic certainization helped establish claims that rivaroxaban was efficacious and cost-effective.
- Their findings about the media partly support countervailing powers theory.
- Their findings about industry and regulators support corporate bias theory.
- The article examines the controversy using documentary and interview data.
Disclosure
- Research title:
- Rivaroxaban controversy linked to synthetic certainty
- Authors:
- Gowree Balendran, John Abraham
- Institutions:
- Keele University, Brighton and Sussex Medical School
- Publication date:
- 2026-03-09
- OpenAlex record:
- View
Get the weekly research newsletter
Stay current with peer-reviewed research without reading academic papers — one filtered digest, every Friday.