Modification talk:Sciento-2019-0013

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Provide your comments regarding the suggested modification here. At minimum you need to indicate whether you think the modification is acceptable, why "yes" or why "no". The key question here is not whether the modification is flawless - no modification ever is. The key question is whether the modification, if accepted, will provide an overall improvement to our communal knowledge.

Please follow the instructions in the guidelines for readers.


Ameer Sarwar

46 months ago
Score 0

I think this modification should be accepted. The authors clearly show that in clinical epidemiology studies that relax one or more of the requirements of the randomized control trials (RCT) can be accepted provided that studies on the same topic that satisfy the RCT requirements have not been performed.

I wish to make two comments. First, the authors claim that they are using a "conservative approach" in their use of the indicators. Specifically, they claim that "each of the studies discussed below are published in prestigious journals and the respective therapies and techniques are widely used in practice" (p. 46). I think this is a reasonable criteria for indicators. However, one of the studies they discuss does not satisfy the bit about widespread use. In their discussion of RAMIT, the authors report that the "specific recommendations regarding the structure of such programs [that were examined in RAMIT] are not presented in guidelines, consistent with the findings of [RAMIT] which found that formal rehabilitation programs were not better than "usual care"" (p. 53). This suggests that the findings of RAMIT are NOT used in clinical practice, thus violating part of the requirement for reliable indicators.

Second, I do not think the question about conceptualizing method hierarchies needs to be addressed a priori. I am inclined to believe that having individual employment records is a better approach. Once we have these records, a scientonomist may argue -- and others may disagree -- whether there is enough evidence to suppose a method hierarchy. But we need not theoretically solve how to approach the problem. I think a pragmatic approach is more reasonable.

In any case, the overall modification should be accepted.

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