Finding “the best” way

Yet another study announced which aims to find “the” best way – this time the best way to treat anorexia nervosa.¬† As reported in The Age:

Australian researchers will conduct a world-first study to find the optimal treatment for the debilitating, and often deadly, disorder anorexia nervosa. Around one in five people, usually women, who develop the eating disorder would die as a result, says Associate Professor Susan Byrne from the University of WA’s School of Psychology.

She said many treatments had emerged over the years, from different models of counselling and therapy along with acute hospital care, though there was little evidence to show which approach was best.

“Currently, there are a whole range of treatments and we don’t have any evidence that one is any better than the other,” Dr Byrne said on Friday.“… We’re really trying to gather some evidence so we can say to people, with confidence, that we have evidence that this or that treatment is helpful.”

Dr Byrne is seeking around 200 adult volunteers who have an eating disorder and who are based in Sydney, Adelaide or Perth. Participants will receive ten months of free treatment – in one of three different front-line therapies developed independently and used by some to tackle anorexia in different parts of the world.

The research will compare Enhanced Cognitive Behaviour Therapy, developed at Oxford University; Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), developed at London’s Maudsley Hospital; and New Zealand’s Specialist Support Clinical Management for Anorexia Nervosa.

I would have hope that after all this time and effort developing evidence-based policy and practice  it would be widely understood that:

  1. One size rarely fits all. Universal “one size fits all” prescriptions of practice are very often inappropriate for some sub-groups.
  2. One study cannot answer this question. A a single study, no matter how large or well-designed and implemented, will have serious limitations compared to a synthesis of multiple studies that tries to take account of all credible evidence about comparative effectiveness and situational appropriateness.

Perhaps it is due to the way the study has been reported, rather than the way it has been actually proposed.¬† Let’s hope that is the case.

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