The antidepressant-debunking study

[substitute]

There was a news release today about a study that appears to show the uselessness of popular antidepressants.

This was reported in the Guardian, among other places. The publication can be read here.

There are problems, as summarized:

1. PlOS is not an academic peer-reviewed journal. edit: They are in fact peer-reviewed, based on better information I have received by comments. Read the threads. They say they are peer-reviewed, but when you read their FAQ, you'll see this: "We involve the academic community in our peer review process as much as possible. After professional staff have determined that the paper falls within the scope of the journal, and is of a minimum acceptable quality, decisions on whether to send a paper out for in-depth review are made via a collaboration between experienced, professional editors who work full time at PLoS, and academic editors who are experts in their field."
   
   I'm not saying this is Wikipedia, but it's not the same thing as a traditional journal, either.
   
   
2. It's one study. Beware of an equivalency between "one metastudy showed that these three or four drugs didn't show a good outcome under these conditions" and "antidepressants don't work."
   
   
3. The study measured outcomes at six weeks. That isn't very long in a depression treatment, whether you're using Prozac or a trampoline.

That having been said, anything that keeps family doctors from throwing the best-advertised drug at every problem is going to be helpful at this juncture. And using any kind of medication (except possibly the trampoline) without counseling is, well, crazy.

Comments

Re: Peer-review

[substitute.livejournal.com]

That is good to know. It makes me much more likely to accept this as a study worthy of replication and criticism.

I do hope that it's single-blind reviewing, though!

Thanks for the in depth information.

Re: Peer-review

[(Anonymous)]

You are welcome.

Also, just to note as there is some confusion out there, ALL of PLoS journals are reviewed in this way, including PLoS ONE.

There is a lot of discussion about the pros and cons of different styles of review. Open review and double-blind review have their strengths. Single-blind is universally thought as horrible as it preserves the hierarchy, has a definite gender bias, Big-School bias and Anglo-American bias, i.e., compared to both Open and Double-Blind, it has much more and stonger cons than pros.

Re: Peer-review

[substitute.livejournal.com]

I do understand the need for reform of the bias you listed above. As a consumer of science rather than a producer, I want the system that provides the most reduction in bias *and* a review system that allows harsh criticism with the minimum of risk to the reviewer. I suppose double-blind would be that?

Re: Peer-review

[catamorphism.livejournal.com]

It's not really obvious whether double-blind reviewing reduces implicit bias. You can still guess at who the author of a paper is, at least if they're in your community, and things like writing style provide subtle cues. I attended a conference that used double-blind reviewing (which isn't usual in my field) where the program chair basically gave the justification for it as wanting everyone's papers to get equal reviewing time -- avoiding the situation where some reviewer spends 3 hours reading their friend's paper, and 15 minutes reading the paper by someone they haven't heard of -- rather than reducing bias.

I think the only way to reduce bias is to get people to stop being bigoted assholes.

Both single-blind and double-blind reduce risk to the reviewer, but not entirely, because you still get situations where some eminent personality is willing to walk into a room full of people who were on the program committee and yell "Those assholes rejected our paper!" (and he at least knows the set of 16 people that those assholes were drawn from, even if he doesn't know who the specific assholes were who reviewed his paper -- but he's sure certain that they're assholes, whoever they are. Not that I've ever seen that happen.)

Re: Peer-review

[substitute.livejournal.com]

I think the only way to reduce bias is to get people to stop being bigoted assholes.

Ouch, good luck with that.

I agree that all possible viewpoints on the situation are horribly flawed. And I've worked in the sausage factory there too.