For 4.5 of RoB 2 they give "patient-reported symptoms in trials of homeopathy" as an example of an outcome where knowledge of intervention received would be likely to influence assessment of outcome. Why do you think this would be less of an issue with CBT?
That being said, we agree that it's likely not possible to run a trial at less risk of bias on this topic so why does it matter? This is probably the best you can get, doesn't mean CBT is 100% effective but it does provide some fairly strong evidence
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I don't agree! eg I linked to this old RCT of CBT for CFS that included a placebo & drug arm, helping to account for problems with bias: https://www.amjmed.com/article/0002-9343(93)90183-P/abstract … Also, if A vs A+B trials & subjective self-report outcomes provide fairly strong evidence for CBT, they do for CAM too.pic.twitter.com/DHXuYOlk4q
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Rgardless of the merits of this trial design, researchers should make clear to readers, patients & journalists that reported improvements may merely reflect problems with bias. We can't be certain how much this is a problem but people should be informed of risk.
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