To the Editor Rutherford et al1 concluded that (1) the standardized mean change (SMC) associated with medication treatment has decreased since 1960 and (2) that attributable causes included “inflation of baseline scores, enrollment of less severely ill participants, and higher expectations of patients.”
Unfortunately, the authors failed to consider other key factors affecting treatment effect size including features associated with the 2 publication periods (1965-1984 vs 1992-2012),2 efficacy and tolerability profiles specific to the individual antipsychotics,3 SMC from the control group,4 and/or the precision of individual trial results.2,4