Posted by SLS on January 5, 2008, at 21:05:34
In reply to Re: correlation does not imply causality, posted by SLS on January 5, 2008, at 19:40:16
Hi.
Please thank Larry Hoover for providing us with the citation I used later in this post.
> > It may be true that 67%...
>
> I thought the STAR*D claimed a success rate of 70%. Where can I find a reference stating that it was 67%? Just curious. Thanks.
>
> > Whereof patients who follow the STAR*D algorithm can be brought into remission, but it is not necessarily as a result of following this algorithm.
>
> Thank God it was the result of something.
>
> > If each treatment phase lasted 14 weeks, that means this 67% figure was attained only after 56 weeks - more than a year!
>
> If you happen to be stricken with depression, how long have you been trying unsuccessfully to treat it? More than 56 weeks? If so, you might want to try following a protocol similar to that used in the STAR*D study.
>
> > Since major depressive episodes often only last a few months, the observed remission may be little more than regression to the mean.
>
> So, you see how the STAR*D investigation thus indicates that there were quite a few members of the study population who were chronic and difficult to treat, otherwise their depressions would have remitted spontaneously during what you acknowledge is an extended period of time. Where is the selection bias here?
>
> I'll tell you what. For as much as this treatment population remained unremitted at each step, I would conclude that there had not been terribly much conspiracy to be perpetrated. Maybe just a little? There would be no drama if there weren't just a little. Damned NIH liars.
>
> :-(
>
>
> - Scott-------------------------------------
http://ajp.psychiatryonline.org/cgi/content/full/ajp;163/1/28Evaluation of Outcomes With Citalopram for Depression Using Measurement-Based Care in STAR*D: Implications for Clinical Practice
Am J Psychiatry 163:28-40, January 2006
doi: 10.1176/appi.ajp.163.1.28
"RESULTS: Nearly 80% of the 2,876 outpatients in the analyzed sample had chronic or recurrent major depression; most also had a number of comorbid general medical and psychiatric conditions"Brilliant deduction, I must say.
The STAR*D seems to present itself logically and simply to me; its results consistent such that they beg me to take them at face value.
Only a simple mind such as my own would find such a simple study to be so simple.
- Scott
poster:SLS
thread:804126
URL: http://www.dr-bob.org/babble/20080105/msgs/804547.html