To the Editor: In stating that "in this study,
St John's wort was not effective for treatment of major depression," Dr Shelton
and colleagues1 have made the same error
they criticized in earlier studies of St John's wort vs standard antidepressants.
Failure to find statistically significant differences between 2 treatments,
they correctly note, does not alone support a conclusion of equal efficacy.
Nonetheless, the authors inappropriately interpreted failure to detect statistically
significant differences with placebo as evidence of equal lack of efficacy.
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