I don't find the exhortation to abandon per-protocol analysis very compelling without even a basic attempt to understand why educated people acting in good faith would be using it. I'm not a medical research expert, but I can think of at least a few situations off the top off my head where per-protocol studies are useful.
Thanks for your kind, encouraging, and thought-provoking comment Willa :)
Definitely the ideal would have been to write this earlier on- the post itself has been on my list to write for a long time, which probably didn't help. I like the idea of having some kind of objective comparison method- the ideal would be some kind of Rationality score, but I don't know if that kind of thing does/could ever exist, or would even reflect the breadth of change one is likely to experience enough to make it even vaguely useful.
I think "dark night of the soul" works pretty well as a descriptor of the experience we're talking about, although to me... (read more)
This post is roughly analogous to the “before” photos that you see people use to demonstrate the effects of dieting, except I want to use it a sort of time capsule to compare my conception of myself as a thinker now to that conception in [some] years time, when I am further along in my studies of rationality and metarationality.
To contextualise the picture of a flabby, sad looking brain that I take today, I should probably describe my exploration of those concepts so far.
Rationality first: I study in a field that is somewhat based on principles of rationality but in terms of day to day thinking relies much more on pattern recognition... (read 1109 more words →)
Do you have much evidence of a time when medical researchers have been misled by a per-protocol analysis into advancing a treatment which, were it analysed using an intention-to-treat analysis, would not have been taken forward?
As one of I'm sure many good examples of the utility of per-protocol analysis; this study, looking at whether routine screening with colonoscopy reduces the risk of colorectal cancer. In the intention-to-treat analysis (examining those who were invited to be screened), the difference in death rate wasn't significant. In the per-protocol analysis (examining... (read more)