Posted by ShelliR on April 20, 2001, at 23:11:47
In reply to Re: Don't say it's just placebo, posted by mikes on April 20, 2001, at 21:10:14
> >Main Outcome Measures The primary outcome > measure was rate of change on the HAM-D over > the treatment period. Secondary measures > included > the Beck Depression Inventory (BDI), > Hamilton > Rating Scale for Anxiety (HAM-A), the > Global > Assessment of
> Function (GAF) scale, and the Clinical Global > Impression–Severity and –Improvement >
scales (CGI-S and CGI-I). >Results The random coefficient analyses for the > HAM-D, HAM-A, CGI-S, and CGI-I all
> showed significant effects for time but not for > treatment or time-by-treatment interaction
> (for HAM-D scores, P< .001, P = .16, and P = .58, > respectively). Analysis of covariance showed > nonsignificant effects for BDI and GAF scores. > The proportion of participants achieving an a > priori definition of response did not differ > between groups. The number reaching remission >of illness was significantly higher with St John's > wortthan with placebo (P = .02), but the rates > were very low in the full intention-to-treat > analysis (14/98 [14.3%] vs 5/102 [4.9%], respectively). < <
Okay, this is the part that confuses me. (It's been a long time since I've taken statistics and methodology). So maybe someone can explain this:The number reaching remission of illness was significantly higher with St John's wort than with placebo (P = .02). Is this coming out of the analysis of the HAM-D alone? But then correlating the HAM-D with each of the other tests showed no significant difference? This is what I am having trouble interpreting.
Whatever, remember each study set up it's own hypothesis and choose its tests and cross analysis. So first of all, you have to consider that the criteria was set up by the testers, and then you have to consider whether the criteria really justified the results (no improvement for major depression). That's why I was trying to understand the parts of the analysis.
Next the part I am not confused about. As Mike said, St. John's Wort has only been recommended for mild to moderate depression. So even if the criteria is valid, nothing new has come out of this study. I believe it was well known in Europe and more recently in the U.S. that St. John's Wort was not recommended for treatment of major depression.
There is absolutely nothing in this study that would indicate that any positive results from St. John's wort could only be accounted for by placebo effect.
NIMH has sponsored a large study to analyze St. John's Wort against other medications. (going on now). Hopefully they will also measure it against placebo for less than major depression. And it's not being funded by a drug manufactorer, so that in itself is a plus.
Shelli
poster:ShelliR
thread:60343
URL: http://www.dr-bob.org/babble/20010417/msgs/60641.html