title: Systematic review of blinding assessment in randomized controlled trials in schizophrenia and affective disorders 2000-2010.
abstract: BACKGROUND
  Blinding is an integral part of many randomized controlled trials (RCTs). However, both blinding and blinding assessment seem to be rarely documented in trial reports.
  
  
  METHODS
  Systematic review of articles on RCTs in schizophrenia and affective disorders research during 2000-2010.
  
  
  RESULTS
  Among 2,467 publications, 61 (2.5%; 95% confidence interval: 1.9-3.1%) reported assessing participant, rater, or clinician blinding: 5/672 reports on schizophrenia (0.7%; 0.3-1.6%) and 33/1,079 (3.1%; 2.1-4.2%) on affective disorders, without significant trends across the decade. Rarely was blinding assessed at the beginning, in most studies assessment was at the end. Proportion of patients' and raters' correct guesses of study arm averaged 54.4 and 62.0% per study, with slightly more correct guesses in treatment arms than in placebo arms. Three fourths of responders correctly guessed that they received the active agent. Blinding assessment was more frequently reported in papers on psychotherapy and brain stimulation than on drug trials (5.1%, 1.7-11.9%, vs. 8.3%, 4.3-14.4%, vs. 2.1%, 1.5-2.8%). Lack of assessment of blinding was associated with: (a) positive findings, (b) full industrial sponsorship, and (c) diagnosis of schizophrenia. There was a moderate association of treatment success and blinding status of both trial participants (r = 0.51, p = 0.002) and raters (r = 0.55, p = 0.067). Many RCT reports did not meet CONSORT standards regarding documentation of persons blinded (60%) or of efforts to match interventions (50%).
  
  
  CONCLUSIONS
  Recent treatment trials in major psychiatric disorders rarely reported on or evaluated blinding. We recommend routine documentation of blinding strategies in reports.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany. cbaethge@uni-koeln.de
authors.forename: Christopher
authors.initials: C
authors.lastname: Baethge
authors.forename: Oliver P
authors.initials: OP
authors.lastname: Assall
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D015982:Bias; D004311:Double-Blind Method; D006801:Humans; D019964:Mood Disorders / Q000628:therapy; D017063:Outcome Assessment, Health Care; D011643:Publishing / Q000592:standards / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D058028:Research Report / Q000592:standards*; D012559:Schizophrenia / Q000628:therapy; D016037:Single-Blind Method