BMJ  2005;330:730-731 (26 March), doi:10.1136/bmj.330.7493.730-b

Letter

Authors of TADS study reply to letter raising concerns

The first 150 words of the full text of this article appear below.

EDITOR—We thank Jureidini et al for their interest in the treatment for adolescents with depression study (TADS) study¹ but find their critique to lack accuracy, methodological sophistication, scientific rigour, and credibility.

TADS does not consist of "two separate randomised studies." Patients were consecutively randomised to one of the four TADS treatments using a computerised, stratified randomisation algorithm.^{2 3} Because comparative treatment trials that include both medication and psychotherapy conditions can double blind the conditions treated with medication only, but not those treated with psychotherapy, TADS employed an independent evaluator blind to treatment assignment, while placebo served as a credible, trial wide control.² These are design choices, not design flaws.^{2 3}

Jureidini et al confuse statistical significance with the magnitude of clinical effect. In TADS, combined treatment with fluoxetine and cognitive behaviour therapy proved superior to placebo and to cognitive behaviour therapy on five of five measures. Fluoxetine alone proved superior . . . [Full text of this article]

Duke University Child and Family Study Center, 718 Rutherford Street, Room 132, DUMC 3527, Durham, NC 27710, USA jsmarch@acpub.duke.edu

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