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The number everyone quotes
Publication bias is about which trials you get to see. There is a second, subtler issue. How a single trial gets written up in the first place.
The most influential antidepressant study ever run is probably STAR*D. It was large (more than 4,000 people), publicly funded, and designed to answer a practical question. If the first medication does not work, and you keep trying others, how many people eventually get better? The headline answer, published in 2006, was a cumulative remission rate of about 67%. That figure became something close to clinical common sense, repeated in textbooks, guidelines and news articles for years.
In 2023, an independent team went back to the original patient-level data and reran the numbers using the study’s own pre-registered protocol.
Their result came out closer to 35%, roughly half the famous figure, because of choices made along the way about who counted and how. The original investigators dispute the reanalysis and stand by their numbers. That argument is still live, and reasonable people are on both sides.
Notice what made that disagreement possible. The raw data had been preserved and shared, so outsiders could check the working. That is the system functioning, not failing. The point is not that one number is right and the other wrong. It is that a headline figure and the data beneath it are not always the same thing, and you are allowed to ask to see it.
What gets the research budget
Here is a quieter point that took us a while to appreciate, and it is less of a conspiracy than it sounds.
A company will spend hundreds of millions running a trial when there is a patent at the end of it. A monopoly, a sales force, years of protected revenue. That investment makes sense when you can own the result.
Now ask who funds the large, glossy campaigns for the things nobody can own. Sleep. Sunlight. Exercise. A walk outside. There is no patent on any of it, so there is rarely a marketing budget behind it. That does not make those things magic, and it does not make them worthless. It simply means the volume of attention an idea gets is not always a measure of how true or useful it is. It is often a measure of who stood to gain from telling you about it.
Where we stand, plainly
We are not here to tell you what to take, and we are not making any claim about treating or curing anything. That is genuinely not our place.
What we believe in is much simpler. You deserve the full picture rather than the highlight reel, and you are perfectly capable of reading the source material yourself. Not a passive recipient of a tidy sentence. A curious adult who follows the footnotes.
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