web only notes 11/2/48

As a result of the small number of participants in arms that allowed comparison of cognitive therapy with pharmacotherapy, the study has reduced power. Authors� post hoc power calculation suggests the study had power to detect only large differences between treatments in remission rates (over 20% difference). For the primary outcome, authors used a conservative intention to treat analysis (assumed that people with missing HAM-D scores did not achieve remission). The study did not provide a comparison between augmentation and switch strategies. The design of the STAR*D study may have led to bias in the participating sample, as the proportion of people who accepted psychotherapy was lower than expected.