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Contradictions and initial overestimates are not unusual among highly
cited studies. However, this issue has not been researched in
To assess how highly cited studies in psychiatry are replicated by
We selected highly cited studies claiming effective psychiatric
treatments in the years 2000 through 2002. For each of these studies we
searched for subsequent studies with a better-controlled design, or with
a similar design but a larger sample.
Among 83 articles recommending effective interventions, 40 had not been
subject to any attempt at replication, 16 were contradicted, 11 were
found to have substantially smaller effects and only 16 were replicated.
The standardised mean differences of the initial studies were
overestimated by 132%. Studies with a total sample size of 100 or more
tended to produce replicable results.
Caution is needed when a study with a small sample size reports a large
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