AACAP Dispatch, Day 2: Don't Break the Blind!

When does blinding matter in clinical trials?

The Frontier Psychiatrists is a daily health-related newsletter. People ask me “what I do” at the child psychiatry conference I attend. I explain that I am a “muckety-muck” and advocate for change. This is not a real job. However, this is one of those articles. I have a real job—seeing patients and running clinical trials at Fermata. We see patients across NY, IL, TX, MA, NJ, CA, and more!

Humans are pattern recognition machines. We are biased toward seeing them. The issue for healthcare and science is that we will imagine patterns with causes regardless of underlying truth.

We also have built-in blinders.

We want to see a pattern. Science uses the opposite bias: we have the null hypothesis— the assumption is that things are not different between intervention and sham or placebo. We say sham in device studies. We are likely to impute difference when there is none.

We use a double-blind design—investigators and the patients should be unaware of random assignment to sham o…