To the Editor Winkelbeiner and colleagues1 questioned the presence of treatment-by-patient interaction in antipsychotic drugs as their meta-analysis yielded a variance ratio (VR) below 1. The authors correctly stated that their study cannot rule out treatment-by-subgroup interactions. Actually, the authors cannot rule out treatment-by-patient either because treatment-by-subgroup interaction may entirely cancel out the association of treatment-by-patient interaction with VR.
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Bae S. Is Variance Ratio a Valid Indicator of Heterogeneous Treatment Effect? JAMA Psychiatry. 2020;77(2):216–217. doi:10.1001/jamapsychiatry.2019.3372
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