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Comment & Response
November 6, 2019

Is Variance Ratio a Valid Indicator of Heterogeneous Treatment Effect?

Author Affiliations
  • 1Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
  • 2Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, Maryland
JAMA Psychiatry. Published online November 6, 2019. doi:https://doi.org/10.1001/jamapsychiatry.2019.3372

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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