I've thought about this a bit more. If I am not way off, the trial design actually makes even less sense than it would at first glance.
What is the purpose of introducing SMC at all instead of just comparing LP to control?
Even those that are regarded as specialists (Montoya et al) do vary greatly in their approaches. I doubt they actually got people that would remotely be regarded as experts for this study to deliver their 'SMC', so it is even less clear what exactly this term even means and literally all it does is induce a source of bias that is almost impossible to correct for. This is like that one study from a couple of decades ago where the question was whether chocolate consumption has any effect on the skin (with regards to pimples and so on) and all they did was to tell people not to eat chocolate, but did not look at what the subjects replaced their calories with - so it was conceivably other sweets. Their ridiculously over-extrapolated conclusion (that diet makes no difference to skin whatsoever) could be found in textbooks decades later.
I suppose their intention may have been to test LP under 'realistic' circumstances, but to do that one would have had to:
- Find some 'actual' ME patients (i.e. use stricter criteria, this will at the current point in time always be imperfect)
- Try to induce iatrogenic PTSD via several years of neglect and abuse to accurately reflect what is usually happening
- Split into the PTSD and the non-PTSD group (it does not work for everyone, some are more resilient), split those again into control and LP arms
- Compare outcomes
...and EVEN THEN you still would only have measured how much you got people to change their replies on questionnaires.
What is the purpose of introducing SMC at all instead of just comparing LP to control?
Even those that are regarded as specialists (Montoya et al) do vary greatly in their approaches. I doubt they actually got people that would remotely be regarded as experts for this study to deliver their 'SMC', so it is even less clear what exactly this term even means and literally all it does is induce a source of bias that is almost impossible to correct for. This is like that one study from a couple of decades ago where the question was whether chocolate consumption has any effect on the skin (with regards to pimples and so on) and all they did was to tell people not to eat chocolate, but did not look at what the subjects replaced their calories with - so it was conceivably other sweets. Their ridiculously over-extrapolated conclusion (that diet makes no difference to skin whatsoever) could be found in textbooks decades later.
I suppose their intention may have been to test LP under 'realistic' circumstances, but to do that one would have had to:
- Find some 'actual' ME patients (i.e. use stricter criteria, this will at the current point in time always be imperfect)
- Try to induce iatrogenic PTSD via several years of neglect and abuse to accurately reflect what is usually happening
- Split into the PTSD and the non-PTSD group (it does not work for everyone, some are more resilient), split those again into control and LP arms
- Compare outcomes
...and EVEN THEN you still would only have measured how much you got people to change their replies on questionnaires.