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Comment & Response
January 2018

Equivalence? Clarifications Required

Author Affiliations
  • 1Department of Psychosomatics and Psychotherapy, University of Giessen, Giessen, Germany
JAMA Psychiatry. 2018;75(1):103. doi:10.1001/jamapsychiatry.2017.3713

To the Editor Barlow and colleagues1 compared a unified cognitive behavior therapy protocol with single-disorder cognitive behavior therapy protocols in anxiety disorders. Unified protocols for broader classes of disorders represent a promising approach. However, several issues need to be clarified.

First, in the study protocol, the authors1 listed 4 measures as primary outcomes without defining 1 of them as primary. Numerous primary outcomes imply several problems, including ambiguity of results, problems for power analysis, and type I error inflation.2 In the article, however, the authors specify only Anxiety Disorders Interview Schedule clinical severity ratings as the primary outcome.1

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