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In Reply As we stated in Supplement 2 of our recent article1, “Blinding has presented a substantial methodological challenge in previous rTMS studies, primarily because clinicians delivering treatment usually knew when active or placebo stimulation was being administered. In most studies, it was also easy for research subjects to distinguish between active and placebo rTMS conditions.” For this reason, we used a parallel study design, instead of a crossover design, for our clinical trial. Indeed, adequate blinding remains problematic for many clinical trials, particularly those that do not involve pharmacological treatment.2
Folmer RL, Theodoroff SM. Assessment of Blinding in a Tinnitus Treatment Trial—Reply. JAMA Otolaryngol Head Neck Surg. 2015;141(11):1031-1032. doi:10.1001/jamaoto.2015.2422