The timing of randomization changes what a trial can attribute to treatment. This study included a training period before the hormone comparison began. Primary report
Study snapshot
Eighteen healthy men aged 65–82 completed an initial 14-week strength-training period before a further 10-week growth-hormone or placebo comparison with training continued. Strength increased during the initial training phase. Growth hormone altered IGF-1 and body-composition measures but did not provide the reported additional strength benefit. Primary report
Our appraisal: put the randomization date on the graph
A graph starting at the first training session could show an impressive overall improvement. That does not mean the later study drug produced it. Changes before treatment assignment cannot be credited to a treatment that had not yet been compared.
For the randomized question, focus on the difference between the subsequent trajectories. A shared training program is part of the background intervention, not evidence that the hormone caused the training response. The correct contrast asks what adding hormone changed relative to continuing the same program with placebo.
The run-in also affects applicability. Participants entering the randomized phase had already experienced structured training. Their response cannot automatically describe the response of previously untrained people beginning both interventions together.
Body-composition and strength outcomes should remain separate. A favorable change in one measurement cannot substitute for an unsuccessful result on another. Before interpreting the trial as a performance study, examine the strength-testing methods, follow-up completeness, uncertainty around the treatment contrast, and adverse events. It is not a basis for a self-directed hormone regimen.
Frequently asked questions
Did training begin before the hormone comparison?
Yes. There was a 14-week training run-in.
Can run-in gains be attributed to growth hormone?
No. They preceded the randomized treatment comparison.
Did the report find an added strength benefit?
No. The reported hormone comparison did not establish one.
Are composition and strength interchangeable?
No. They answer different measurement questions.
Were these previously untreated training beginners at randomization?
They had already completed the initial training period.
Does the study establish athletic benefit in younger people?
No. That population was not studied here.
What is the key appraisal task?
Separate pre-randomization change from the randomized treatment contrast.