Double-Blinding and Bias in Medication and Cognitive-Behavioral Therapy Trials for Major Depressive Disorder, 2015, Berger

Woolie · Jun 21, 2021

Full reference: Berger, D. (2015). Double-blinding and bias in medication and cognitive-behavioral therapy trials for major depressive disorder. F1000Research, 4.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4732552/

Abstract:

While double-blinding is a crucial aspect of study design in an interventional clinical trial of medication for a disorder with subjective endpoints such as major depressive disorder, psychotherapy clinical trials, particularly cognitive-behavioral therapy trials, cannot be double-blinded. This paper highlights the evidence-based medicine problem of double-blinding in the outcome research of a psychotherapy and opines that psychotherapy clinical trials should be called, “partially-controlled clinical data” because they are not double-blinded. The implications for practice are, 1. For practitioners to be clear with patients the level of rigor to which interventions have been studied, 2. For authors of psychotherapy outcome studies to be clear that the problem in the inability to blind a psychotherapy trial severely restricts the validity of any conclusions that can be drawn, and 3. To petition National Health Insurance plans to use caution in approving interventions studied without double-blinded confirmatory trials as they may lead patients to avoid other treatments shown to be effective in double-blinded trials.
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James Morris-Lent · Jun 21, 2021

1. If there isn't good evidence it generally shouldn't be offered under the umbrella of mainstream medicine
2. If studies are not designed to produce reliable evidence they shouldn't be approved or funded
3. See 1.

ME/CFS Skeptic · Jun 21, 2021

Already discussed here: https://www.s4me.info/threads/bias-due-to-a-lack-of-blinding-a-discussion.11429/#post-203661

Unfortunately, Berger is not uncontroversial.

Woolie · Jun 22, 2021

Thanks, @Michiel Tack! I just independently re-read your previous thread and came here now to link to it myself!

Snow Leopard · Jun 22, 2021

My personal preferred term is "randomised comparison trial", rather than "randomised controlled trial"...

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Double-Blinding and Bias in Medication and Cognitive-Behavioral Therapy Trials for Major Depressive Disorder, 2015, Berger

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