How would you blind and what objective scores do you suggest?
Not sure what you mean by cognitive aspects to treatment, but not necessarily. As I said, RoB assessment can be a bit subjective, but as an example it's literally impossible to blind to CBT, but within that constraint the study was very rigorous, so I'd put it as a "probably no"
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Similarly, subjective measures are pretty difficult to use in a study like this. I can't think of any that are feasible to collect, although happy to be proven wrong. The study did, however, use a large number of subjective measures, all of which improved. So again "probably no"
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If I was to put it all into the RoB 2 calculator it would probably come up with "Some risk of bias", so moderate most likely. Then a judgement call - it's about as rigorous as a study could be on this topic - to say that it's probably moderate-low
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