Lovely interview, Owen. So glad you're out there sharing your story and working for quality public health messaging. And this hit home: "the road to hell is paved with great ideas for what you should do for yourself, and so I try not to be my own doctor to the degree possible".
As both a patient and a physician, Dr. Muir provides a great example of a collaborative relationship between a doctor and a patient that is based on mutual respect and trust. Interestingly, he also experiences that collaboration within himself as an individual who is simultaneously an insightful doctor and an insightful patient. Because certified peer support specialists today have such an influential role in mental health policy in my community, one that is sometimes frustrating to me as a parent caregiver for an adult living with schizophrenia, it is this combination that I would like to see more often: Replace the disrespect, distrust, and unawareness I too often hear in contentious arguments about treatment and civil rights with true collaboration. Bravo, Dr. Muir!
Wonderful interview, loved getting to know Dr. Muir's story.
> To give you an example, the randomized control trial of fMRI guided SAINT was halted at an interim analysis by the institutional review board because it showed a large effect size and it would’ve been unethical to continue withholding this highly effective treatment from suffering people.
Is it widely accepted the observed effect size in unbiased and free from magnitude errors? I'm curious if there are any arguments of such a nature that have been well received amongst clinicians.
It's depends who is in your trial and the rate of placebo response in that population.
In the case of Saint, they enrolled highly treatment or Factory individuals and had a vanishing low placebo response (sham is the term in device trials)
It's not ethical to study parachute versus sham parachute, because the rate of death is 100%. In the framing of any question, you end up with a similar issue.
Lovely interview, Owen. So glad you're out there sharing your story and working for quality public health messaging. And this hit home: "the road to hell is paved with great ideas for what you should do for yourself, and so I try not to be my own doctor to the degree possible".
Thanks Carl. Appreciate it from you, especially
As both a patient and a physician, Dr. Muir provides a great example of a collaborative relationship between a doctor and a patient that is based on mutual respect and trust. Interestingly, he also experiences that collaboration within himself as an individual who is simultaneously an insightful doctor and an insightful patient. Because certified peer support specialists today have such an influential role in mental health policy in my community, one that is sometimes frustrating to me as a parent caregiver for an adult living with schizophrenia, it is this combination that I would like to see more often: Replace the disrespect, distrust, and unawareness I too often hear in contentious arguments about treatment and civil rights with true collaboration. Bravo, Dr. Muir!
Thanks so much!
Wonderful interview, loved getting to know Dr. Muir's story.
> To give you an example, the randomized control trial of fMRI guided SAINT was halted at an interim analysis by the institutional review board because it showed a large effect size and it would’ve been unethical to continue withholding this highly effective treatment from suffering people.
Is it widely accepted the observed effect size in unbiased and free from magnitude errors? I'm curious if there are any arguments of such a nature that have been well received amongst clinicians.
It's depends who is in your trial and the rate of placebo response in that population.
In the case of Saint, they enrolled highly treatment or Factory individuals and had a vanishing low placebo response (sham is the term in device trials)
It's not ethical to study parachute versus sham parachute, because the rate of death is 100%. In the framing of any question, you end up with a similar issue.