Thursday, February 9, 2023

Comments by ThorG

Showing 2 of 2 comments.

  • Thanks for the link. I stand with my previous comments as it is unclear to me how data on the treatment relates to the results. It seems that the baseline data is already treated patients in which case they demonstrate only that the more depressed people are, the more treatment they recieve. You certainly cannot conclude much with regard to treatment effects. The author states: At best, treatment was insufficient to overcome liabilities among persons with MDD in the current sample. That is true, however a negatively biased conclusion. Second he concludes: Moreover, treat-
    ment including medication may have worsened depression. This could be technically true as “may have” allows for wide intrepretation, but given the huge selection bias it is not fair.
    Unlike the headline the report in itself is not rigorous, but should be better explained, so that it is much more clear what we really can learn from the data – and much less what is the authors idea/opinion on the matter.
    These issues are really complicated, so adhering to what data says is paramount, not adhering to our own opinion!

  • I cannot see how this study shows what the author concludes. I can only acces the front page of the article so it may be my mistake, but it seems that he data on treatment was from the past year (being year 8 to 9). In which case the resuts just shows that the sicker you are, the more treatment you recieve and that the treatment is not sufficient to alleviate the worsening. All this is to be expected and changes nothing to current knowledge. What could be interesting is to see what the treatment effect was to those who recieved treatment from year 0 to 1 and then normalize the data vis-a-vis the present treatment to understand how treatment effects may change over time?
    In any case however, everyone should be very clear that you cannot infer casual relationsshios with these types of data. The risk of residual confounding is substantial and alone calls for considerable moderation in the intrepretation no matter what.