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How to prove that your therapy is effective even when it is not: A guideline

@Bob drew my attention to this funny and astute article, and I couldn't see any post about it already. So here it is.

How to prove that your therapy is effective, even when it is not: a guideline
P. Cuijpers and I. A. Cristea

Abstract said:
Suppose you are the developer of a new therapy for a mental health problem or you have several years of experience working with such a therapy, and you would like to prove that it is effective. Randomised trials have become the gold standard to prove that interventions are effective, and they are used by treatment guidelines and policy makers to decide whether or not to adopt, implement or fund a therapy.
You would want to do such a randomised trial to get your therapy disseminated, but in reality your clinical
experience already showed you that the therapy works. How could you do a trial in order to optimise the chance of finding a positive effect?
Methods that can help include a strong allegiance towards the therapy, anything that increases expectations
and hope in participants, making use of the weak spots of randomised trials (risk of bias), small sample sizes and waiting list control groups (but not comparisons with existing interventions). And if all that fails one can always not publish the outcomes and wait for positive trials.
Several methods are available to help you show that your therapy is effective, even when it is not.

Here are some excerpts that will make many of you smile:

the paper said:
Increase expectations in patients
...it is very well possible to strengthen expectations and hope in participants to the therapy. Just express your own belief to them, namely that this is the best therapy currently available. And you can advertise for your trial in the media explaining why your intervention is so innovative and unique and definitely the best among the available interventions.
... Ask a few participants to declare that they have benefited very much from the therapy and tell their personal stories. You can also go to conferences and testify about your clinical experiences with the therapy, give educational workshops on the therapy where you present successful case studies, and convince other deliverers of treatments that this is really something new, surprisingly effective and definitely worth trying on patients. If and when they start using it, they will also increase expectations and hope in the participants, who in their turn will indeed experience how good this therapy is.

the paper said:
Use the "Weak Spots" of Randomised Trials
... another weak spot of trials is in the use of outcome measures. So, if you want to make use of this weakness, you should include multiple outcome measures, and then when you analyse the results you can simply look at which outcome measure has the best results. Then you present these outcomes in your reports and simply not mention the other measures or sweep them under the rug as secondary. This ‘selective outcome reporting’ is getting more and more difficult to realise because the protocol of trials are now more often published, which allows reviewers to verify whether the reported outcomes were also the ones that were planned. However, not all protocols of trials are published in trial registries, so this still remains an available option. Even in the cases where protocols are published, a number of problems easily go unnoticed (Coyne & Kok, 2014). Information in trial registries can be modified and even if in most registries these changes are saved and can potentially be browsed, reviewers, clinicians and patients seldom take on the painstaking operation of going through them.

You can access the entire paper for free through ResearchGate (not sure if you have to be a member though):
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