Strengths and limitations
SSHL
RECRUITMENT
The strength of this study is the placebo-controlled design displaying the high placebo response rate. The major limitation is the early study termination due to patient recruitment difficulties that does not allow drawing conclusions on efficacy. Consequently, other study limitations are the demanding in- and exclusion criteria, and the complex study protocol and logistics that resulted in the involvement of predominantly tertiary referral centers. In these limitations, on the contrary, lies a strength of the study: the lessons learned allow investigators to draw conclusions for designing future study protocols on SSHL.