Reposted by David LaursenCochrane Denmark & CEBMO @cochranedkcebmo.bsky.social · 29/09/2026Learn 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/ 011
David Laursen @davidlaursen.bsky.social · 29/08/2026Just found out that "monkey class" is a pseudo-anglicism used in Danish. So would have to go with: X-Men: Economy Class 002
David Laursen @davidlaursen.bsky.social · 28/08/2026Darn it, should've led with: X-Men: Monkey Class 200
David Laursen @davidlaursen.bsky.social · 20/08/2026Hmm, curious! Might you know any good papers on differences in effect between patient-reported outcomes and MADRS/HAMD? 100
David Laursen @davidlaursen.bsky.social · 19/08/2026BTW 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? 101
David Laursen @davidlaursen.bsky.social · 19/08/2026Regarding 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... 211
David Laursen @davidlaursen.bsky.social · 19/08/2026Interesting 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? 211
David Laursen @davidlaursen.bsky.social · 19/08/2026Either 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. 111
David Laursen @davidlaursen.bsky.social · 19/08/2026Thanks 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? 211
David Laursen @davidlaursen.bsky.social · 18/08/2026Whoops, ref shouldn't be here yet, but in post 3. 000
David Laursen @davidlaursen.bsky.social · 18/08/2026Would probably be nice with a stronger analysis of patient-reported vs observer-reported outcomes in the same domain within the same trials/studies? 100
David Laursen @davidlaursen.bsky.social · 18/08/2026Refs: Study 1: www.cochranelibrary.com/cdsr/doi/10.... Study 2: www.jclinepi.com/article/S089... + corrigendum: www.jclinepi.com/article/S089... 3/4jclinepi.comImpact of active placebo controls on estimated drug effects in randomized trials: a meta-epidemiological studyOur 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 ... 100
David Laursen @davidlaursen.bsky.social · 18/08/2026Empirically: 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. 2/4 100
David Laursen @davidlaursen.bsky.social · 18/08/2026Interesting 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. 1/4jclinepi.comImpact of active placebo controls on estimated drug effects in randomized trials: a meta-epidemiological studyOur 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 ... 200
David Laursen @davidlaursen.bsky.social · 18/08/2026Thanks 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."? 110
David Laursen @davidlaursen.bsky.social · 10/08/2026To 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). 020
David Laursen @davidlaursen.bsky.social · 10/08/2026Thanks to @lasseostengaard.bsky.social for leading this nice project - and to my other co-authors (incl @bruunkorfitsen.bsky.social). 4/4 010
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 3/4cochrane.orgHandbooks and manuals | Cochrane 100
David Laursen @davidlaursen.bsky.social · 10/08/2026PRISMA 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/... 2/4bmj.comThe PRISMA 2020 statement: an updated guideline for reporting systematic reviewsThe 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... 100
David Laursen @davidlaursen.bsky.social · 10/08/2026PRISMA 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/... 1/4onlinelibrary.wiley.comPRISMA 2020 Is a Reporting Guideline for Systematic Reviews but Is Often Misused to Guide Review ContentIntroduction 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... 251
David Laursen @davidlaursen.bsky.social · 06/07/2026Where 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. 9/9 030
David Laursen @davidlaursen.bsky.social · 06/07/2026What 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... 8/9 120
David Laursen @davidlaursen.bsky.social · 06/07/2026Hopefully, 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. 7/9 130
David Laursen @davidlaursen.bsky.social · 06/07/2026We 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. 6/9 120
David Laursen @davidlaursen.bsky.social · 06/07/2026We 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. 5/9 100
David Laursen @davidlaursen.bsky.social · 06/07/2026The studies reflected on criteria such as: matching of perceptible side effects, ensuring lack of therapeutic effect, blinding success, protection against bias etc. 4/9 100
David Laursen @davidlaursen.bsky.social · 06/07/2026Collectively, 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. 3/9 100
David Laursen @davidlaursen.bsky.social · 06/07/2026We found 15 studies describing the development process for active placebo controls, covering psychiatry and pain, psychedelics and similar. 2/9 100
David Laursen @davidlaursen.bsky.social · 06/07/2026Do 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 1/9 112
David Laursen @davidlaursen.bsky.social · 19/06/2026Happy 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 150
David Laursen @davidlaursen.bsky.social · 24/05/2026Zoom link: syddanskuni.zoom.us/j/6537103741... 010
David Laursen @davidlaursen.bsky.social · 24/05/2026At least it wasn't unblinging ... bsky.app/profile/drro... 030
David Laursen @davidlaursen.bsky.social · 24/05/2026Looking 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 221
David Laursen @davidlaursen.bsky.social · 15/04/2026Studies concerned complementary and alternative medical treatments, but mechanisms of bias though e.g. expectation likely similar in psychology? 000
David Laursen @davidlaursen.bsky.social · 15/04/2026Perhaps 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.govBias due to lack of patient blinding in clinical trials. A systematic review of trials randomizing patients to blind and nonblind sub-studiesBackground: 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... 130
David Laursen @davidlaursen.bsky.social · 07/04/2026Yes, typically. The classic example is atropine for imitating the anticholinergic effects of tricyclic antidepressants, e.g. dry mouth. 110
David Laursen @davidlaursen.bsky.social · 07/04/2026Yes, 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. 110
Reposted by David LaursenThe John Snow Society @johnsnowsociety.bsky.social · 26/02/2026Thomas 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.comJohn SnowPhysician, epidemiologist, and anaesthetist. Born in York, UK, on March 15, 1813, he died in London on June 16, 1858, aged 45 years. 2105
Reposted by David LaursenTom Rodebaugh @drrodebaugh.bsky.social · 22/02/2026Typo in student paper: Single-bling randomized control trialmedia.tenor.coma 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. 3324
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"? 130