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David Laursen

@davidlaursen.bsky.social
328 followers 1.3K following 91 posts

Clinical trial methodology, systematic reviews, placebo, blinding

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Reposted by David Laursen
Cochrane Denmark & CEBMO @cochranedkcebmo.bsky.social · 29/09/2026
Learn more about critically appraising diagnostic test accuracy (DTA) studies on 6 Oct on 12:00 CEST. In this webinar, Anne Rutjes will present the QUADAS-3 tool for assessing the risk of bias and applicability in DTA studies. www2.cochrane.dk/quadas-3/
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David Laursen @davidlaursen.bsky.social · 29/08/2026
Just found out that "monkey class" is a pseudo-anglicism used in Danish. So would have to go with: X-Men: Economy Class
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David Laursen @davidlaursen.bsky.social · 28/08/2026
Or maybe: Ibis Styles Budapest Hotel
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David Laursen @davidlaursen.bsky.social · 28/08/2026
Darn it, should've led with: X-Men: Monkey Class
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David Laursen @davidlaursen.bsky.social · 28/08/2026
Downgrade a movie: 007: No time to sleep
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David Laursen @davidlaursen.bsky.social · 20/08/2026
Thank you, I'll take a look :⁠-⁠)
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David Laursen @davidlaursen.bsky.social · 20/08/2026
Thanks!
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David Laursen @davidlaursen.bsky.social · 20/08/2026
Hmm, curious! Might you know any good papers on differences in effect between patient-reported outcomes and MADRS/HAMD?
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David Laursen @davidlaursen.bsky.social · 19/08/2026
BTW if matching/blinding is not possible: Should function outcomes carry more weight, e.g. sick days, school abseenteism, grades, unemployment? Somewhat clinically relevant, and ideally less affected by response bias?
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David Laursen @davidlaursen.bsky.social · 19/08/2026
Regarding drugs such as (es)ketamine. They may be particularly challenging to blind anyway if the experience is part of the suspected therapeutic mechanism? doi.org/10.1021/acsp... doi.org/10.1021/acsp...
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David Laursen @davidlaursen.bsky.social · 19/08/2026
Interesting that you note we only had meta-analyses of mood with observer-reported outcomes. For some reason those reviews apparently did not analyse patient-reported outcomes (or the analyses were not informative for us: need both active placebo and standard placebo trials). Strange?
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David Laursen @davidlaursen.bsky.social · 19/08/2026
Either way, would be nice to explore the relationship between expectancy, blinding success, true effect and final bias. And also whether expectancy (pre/during/post trial) is different for clinicians and patients.
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David Laursen @davidlaursen.bsky.social · 19/08/2026
Thanks for the kind words :) No, we did not consider unblinding tests directly. Challenging since they only part of the suspected causal pathway towards final bias (= altered treatment effect) and may also be affected by (true) therapeutic effect ("benign unblinding") -> thoughts?
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David Laursen @davidlaursen.bsky.social · 18/08/2026
Whoops, ref shouldn't be here yet, but in post 3.
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David Laursen @davidlaursen.bsky.social · 18/08/2026
Would probably be nice with a stronger analysis of patient-reported vs observer-reported outcomes in the same domain within the same trials/studies?
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David Laursen @davidlaursen.bsky.social · 18/08/2026
Refs: Study 1: www.cochranelibrary.com/cdsr/doi/10.... Study 2: www.jclinepi.com/article/S089... + corrigendum: www.jclinepi.com/article/S089... 3/4
jclinepi.com
Impact of active placebo controls on estimated drug effects in randomized trials: a meta-epidemiological study
Our objectives were, first, to assess the impact of active placebo vs standard placebo control interventions on estimated benefits of experimental interventions in pharmacological randomized clinical ...
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David Laursen @davidlaursen.bsky.social · 18/08/2026
Empirically: assuming active placebo vs standard placebo effect differences crudely estimate bias due to unblinding, then no strong signal either direction in our meta-epidemiological studies across topics for patient vs observer outcomes, but limited by imprecision and confounding. 2/4
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David Laursen @davidlaursen.bsky.social · 18/08/2026
Interesting perspective! My contrarian intuition: Patients experience unblinding from side effects more directly/strongly than observer outside + patient-reported outcomes are private and thus more room for influence. 1/4
jclinepi.com
Impact of active placebo controls on estimated drug effects in randomized trials: a meta-epidemiological study
Our objectives were, first, to assess the impact of active placebo vs standard placebo control interventions on estimated benefits of experimental interventions in pharmacological randomized clinical ...
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David Laursen @davidlaursen.bsky.social · 18/08/2026
Thanks for the read! Care to expand on this part: "Clinician rating scales can lead to unblinding and bias compared to patient-reported outcomes. No significant effects were found for self-report instruments in pediatric depression trials,13 though this was not included in this trial."?
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David Laursen @davidlaursen.bsky.social · 10/08/2026
To be more specific regarding "not uncommon": 111 (55%) of 200 systematic reviews cited PRISMA for something else than reporting, typically to guide conduct (but also sometimes to assess conduct/quality).
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David Laursen @davidlaursen.bsky.social · 10/08/2026
Thanks to @lasseostengaard.bsky.social for leading this nice project - and to my other co-authors (incl @bruunkorfitsen.bsky.social). 4/4
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David Laursen @davidlaursen.bsky.social · 10/08/2026
... for proper guidance on conduct, check out these resources instead: Cochrane Handbooks and Manuals: www.cochrane.org/authors/hand... E.g. the Cochrane Handbook for interventions: www.cochrane.org/authors/hand... And JBI's Manual: jbi-global-wiki.refined.site/space/MANUAL 3/4
cochrane.org
Handbooks and manuals | Cochrane
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David Laursen @davidlaursen.bsky.social · 10/08/2026
PRISMA 2020 does touch upon conduct indirectly, e.g., quotes for adequate reporting that also illustrate proper methods. And boxes in the E&E are a nice starting point for methods concepts (e.g. screening and meta-analysis), but ... www.bmj.com/content/372/... www.bmj.com/content/372/... 2/4
bmj.com
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, wh...
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David Laursen @davidlaursen.bsky.social · 10/08/2026
PRISMA 2020 is NOT intended to guide conduct, but reporting. Not uncommon for systematic reviews to write something like: “This review was conducted following the guidelines presented in PRISMA statement...” (freely modified) See our new study: onlinelibrary.wiley.com/doi/10.1002/... 1/4
onlinelibrary.wiley.com
PRISMA 2020 Is a Reporting Guideline for Systematic Reviews but Is Often Misused to Guide Review Content
Introduction The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) is a reporting guideline aiming to facilitate transparent and accurate reporting in systematic reviews. T...
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David Laursen @davidlaursen.bsky.social · 06/07/2026
Where to go from here: Explore theoretically and empirically: impact (e.g. update prev. studies), matching quality, risk of therapeutic, blinding success etc. The above studies could support a formal process ending with guidance for the choice and development of placebo control. 9/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
What about Q1 from the beginning? Are active placebo controls useful for protecting against unblinding bias? Findings from randomised and observational studies are uncertain due to imprecision and heterogeneity. See previous thread: bsky.app/profile/davi... 8/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
Hopefully, our findings may serve as a catalogue and inspiration for trialists, systematic reviewers and methodologists looking at the development and terminology of active placebo controls. 7/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
We looked at different subtypes of active placebo controls (in our meaning), e.g. another ingredient with similar side effects, low dose of the drug, or another ingredients with nonmatching effects. 6/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
We also analysed the terminology related to "active placebo" in research publications in general. Often used for nontherapeutic placebo with side effects (our meaning), but also (less commonly) for therapeutically active controls, interventions with unintended harm or benefit etc. 5/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
The studies reflected on criteria such as: matching of perceptible side effects, ensuring lack of therapeutic effect, blinding success, protection against bias etc. 4/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
Collectively, the studies covered five phases: specification of a satisfactory active placebo, identification of candidates, selection of a "lead", dose finding, evaluation. Evaluation was commonly covered, first four phases less so. 3/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
We found 15 studies describing the development process for active placebo controls, covering psychiatry and pain, psychedelics and similar. 2/9
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David Laursen @davidlaursen.bsky.social · 06/07/2026
Do active placebo controls protect against bias from unblinding - and under what circumstances? And how do researchers develop active placebo controls? For Q1, go to the end. For Q2, see our new paper: www.jclinepi.com/article/S089... #ActivePlacebo #Blinding #Unblinding #Placebo 1/9
Science Dog Meme. Dog working in a lab. No text
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David Laursen @davidlaursen.bsky.social · 19/06/2026
Thank you!
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David Laursen @davidlaursen.bsky.social · 19/06/2026
Happy to have defended my PhD successfully last week. If you want to read what my coauthors and I found out about active placebo controls and unblinding, the thesis is available here: portal.findresearcher.sdu.dk/files/308011... I hope to explore further in my upcoming postdoc.
portal.findresearcher.sdu.dk
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Reposted by David Laursen
Nino Wili @ninowili.bsky.social · 19/06/2026
epdf->pdf in the url
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David Laursen @davidlaursen.bsky.social · 24/05/2026
Zoom link: syddanskuni.zoom.us/j/6537103741...
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David Laursen @davidlaursen.bsky.social · 24/05/2026
At least it wasn't unblinging ... bsky.app/profile/drro...
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David Laursen @davidlaursen.bsky.social · 24/05/2026
*unblinding
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David Laursen @davidlaursen.bsky.social · 24/05/2026
Looking forward to participating in this hybrid seminar and sharing study findings and reflections on blinding, unblinking and active placebo controls in randomised drug trials, on 31 August in Slagelse and on Zoom. #Blinding #Unblinding #Placebo #ActivePlacebo
RESEARCH SEMINAR IN EVIDENCE-BASED PSYCHIATRY
' Active Placebo'
Date: August 31th, 2026
Venue: Meeting Room 3.26, Building 3, 4th floor, Central and Western Zealand Hospital, 
Fælledvej 6, 4200 Slagelse
[...] In randomised trials, participants and 
healthcare personnel are often blinded by comparing the experimental drug with a placebo that 
matches its appearance. However, if the drug has perceptible adverse effects, participants may be 
able to guess which intervention group they have been allocated to. Active placebo controls may 
help prevent this so-called unblinding by mimicking the adverse effects of the drug.
In this seminar, MD and PhD student David Laursen, Cochrane Denmark and Centre for Evidence-
Based Medicine Odense (CEBMO), University of Southern Denmark, will introduce active placebo 
controls and discuss challenges related to their potential impact, development, and terminology.
Professor in Psychiatry and Pharmacology Gesche Jürgens, from the Research Unit for Clinical 
Psychopharmacology, will give a presentation on placebo effects in medicine.
Please register your participation no later than August 17th by contacting Louise Holm Nielsen at 
loniels@regionsjaelland.dk.
Chair: Professor Ole Jakob Storebø
PROGRAM
10:00 – 10:20 Short introduction to the Methylphenidate versus Active Placebo for ADHD in Children and 
Adolescents (MAPACA) project by Ole Jakob Storebø
10:20 – 11:20 Trials, unblinding, and active placebo controls by David Laursen
11:20– 11:35 Short break
11:35 – 12:05 About the placebo effects in medicine by Gesche Jürgens
12:05 – 12:15 Closing comments by Ole Jakob Storebø
It is possible to participate via zoom link: 
https://syddanskuni.zoom.us/j/65371037416?pwd=6LEKv2i3VH8PD9yugR36C764aWI4zf.1
Code: 388202
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David Laursen @davidlaursen.bsky.social · 21/04/2026
Oldie but goldie
Chat screendump. 

Person 1:
()() is not a palindrome but )(() is
also hi

Person 2:
Wait
No uts not
The first one is
Why are you lying to me
Wait need a second
Oh fuck
Oh Jesus
You're right
Oh my god
How
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David Laursen @davidlaursen.bsky.social · 15/04/2026
Studies concerned complementary and alternative medical treatments, but mechanisms of bias though e.g. expectation likely similar in psychology?
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David Laursen @davidlaursen.bsky.social · 15/04/2026
Perhaps somewhat related: a systematic review looking at trials with both blinded and non-blinded patients: pmc.ncbi.nlm.nih.gov/articles/PMC... (Disclosure: the first author is my boss and supervisor)
pmc.ncbi.nlm.nih.gov
Bias due to lack of patient blinding in clinical trials. A systematic review of trials randomizing patients to blind and nonblind sub-studies
Background: Blinding patients in clinical trials is a key methodological procedure, but the expected degree of bias due to nonblinded patients on estimated treatment effects is unknown. Methods: Syste...
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David Laursen @davidlaursen.bsky.social · 07/04/2026
Yes, typically. The classic example is atropine for imitating the anticholinergic effects of tricyclic antidepressants, e.g. dry mouth.
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David Laursen @davidlaursen.bsky.social · 07/04/2026
Yes, interesting that unblinding has not received more attention in the grand scheme of blinding. Although admittedly there have been sporadic discussions since the 1950s. Unsure if active placebo controls may protect, but probably not always.
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Reposted by David Laursen
The John Snow Society @johnsnowsociety.bsky.social · 26/02/2026
Thomas Wakley, the original editor of @thelancet.com was indeed no friend of Dr John Snow. In happier news, the journal published a 'corrected' obituary in 2013: www.thelancet.com/journals/lan... We're glad you had a refreshing visit to the John Snow pub @pwgtennant.bsky.social‬ 😊
thelancet.com
John Snow
Physician, epidemiologist, and anaesthetist. Born in York, UK, on March 15, 1813, he died in London on June 16, 1858, aged 45 years.
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Reposted by David Laursen
Tom Rodebaugh @drrodebaugh.bsky.social · 22/02/2026
Typo in student paper: Single-bling randomized control trial
media.tenor.com
a cat wearing sunglasses and a chain around its neck is sitting on a blue couch .
Alt: a cat wearing sunglasses and a shiny chain around its neck is sitting on a blue couch looking fabulous.
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David Laursen @davidlaursen.bsky.social · 31/01/2026
@spacecowboybooks.bsky.social Thanks for a very useful feed! Only minor quibble: The feed seems to "refresh" every time I go away from it (to another feed) and back - losing my current "reading progress". Other similar feeds do not appear to refresh as often. Possible to reduce "refresh rate"?
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David Laursen @davidlaursen.bsky.social · 27/01/2026
Thanks, I'll take a closer look!
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David Laursen @davidlaursen.bsky.social · 26/01/2026
Casual causal?
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