One thing that is still open after sophie_paris’s answer:
How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?
SleepFixSam said:The dose-response is real but shallow at the top.
I read this differently from SleepFixSam, on substance rather than tone. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.
SleepFixSam said:The dose-response is real but shallow at the top.
All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.
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View ResultsSleepFixSam said:The dose-response is real but shallow at the top.
Thank you — that is the clearest version of this I have read, and I have read a lot of them.
From the other side of the consultation, briefly. Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the correction. That is slower than asserting, and it is the only version that survives being wrong.