Conceptual problems and questionable evidence in defining non-inferiority margins - a reply to Flückiger et al.

Authors

Falk Leichsenring, Nikolas Heim, Christiane Steinert

Published in

Psychotherapy research : journal of the Society for Psychotherapy Research. Pages 1-3. Jul 16, 2026. Epub Jul 16, 2026.

Abstract

From 19 meta-analyses comparing active bona fide treatments, Flückiger et al. (2026) recently calculated a between-group effect size (SMD) of -0.17 for primary outcomes and of -0.16 for secondary outcomes. They suggested using these effect sizes as empirically derived non-inferiority margins. However, Flückiger et al.'s approach is conceptually problematic and lacks empirical support. Without a rationale, empirically found differences between active treatments cannot per se be regarded as non-inferiority margins.

PMID:
42460499
Bibliographic data and abstract were imported from PubMed on 16 Jul 2026.

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