Hm? They both had very similar selection criteria for participants. The main difference was that DiRECT was more rigorous and had better control, making it more likely to reflect an actual difference rather than simply the biases of the study authors
It's hard to compare results across trials, even if they are identical (which these two trials were emphatically not), so I'd be very cautious saying that one approach is "better" without a direct comparison
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It does not need to be " better" it just needs to work. There are about 4 billion people on the planet need to refind metabolic health- Why are we not going all out to figure out how to help them all instead of worrying at which is " better" ?
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It depends on what we're talking about, of course. For someone to use something, it just has to work and be reasonably safe. For governments to fund a treatment, it should ideally be the most cost-effective option
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