There is a lack of studies that address this issue of treatment comparisons. The optic neuritis study was the first attempt to compare oral versus IV steroids and placebo. This study failed to show any benefit from oral steroids. A small study in England revealed similar outcomes for IV steroids and ACTH; however, the numbers of patients were very small, and the study consequently suffered from problems in statistical analysis of the results (a Type II error). Essentially, a Type II error occurs when you compare two treatments in a study and there aren't a sufficient number of patients on each of the treatments. As a result, the benefits may seem not to be different, but the results are not valid. There are a number of other small studies from which valid conclusions are not possible. Valid studies have to be large and as a result are very expensive to conduct.
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