True blinding likely to be impossible for intervention like CBT, but could try to use trial with placebo group that encouraged similar expectations of success, rather than A vs A+B design. eg: https://www.amjmed.com/article/0002-9343(93)90183-P/abstract …
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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re cognitive aspects. eg:That participants knew they were being encouraged to adopt cognitive strategies emphasising a sense of control, etc, make it difficult to judge that lack of blinding was unlikely to have on influence on self-reports on how IBS interferes with their life.
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