My guess is that a person who is a Rett's caregiver has their hands full. Continuous supervision, continuous care, then add medicine, then add regular doctor real visits and then add trial doctor real and virtual visits. If the drug does nothing at all and the patient is a real handful there would be a tendency for higher dropout rates for the placebo side. -Sugar don't cut it with the hard cases. The Rett's caregiver doesn't want to play in the trial conductor's games for nothing, no effect and no help. Then the Placebo group would have more high-performers and 'non-handful' easier patients. Then the Treated group has all the low-performers and 'handful' hard patients they started with, because the drug works and they can see it. Then let's add perhaps "dumb luck" with a slight imbalance of easy to hard cases favoring the Placebo group with easy cases. These imbalances would then show up in the statistical significance. Dr. Walter E. Kaufman has a reputation, and though most people can rationalize most things, and while I think TGD Missling might be sorely tempted to rationalize this 'severity imbalance' into existence, Dr. Kaufman wouldn't likely make a 'severity imbalance' up from nothing for mere money.
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