[2026 update] What steady state means for the decision to escalate

Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.

That matches what I have seen, for whatever a single anecdote is worth.

Adding the measurement that post #15 says would settle it.

Escalating before steady state means you are judging a dose you have not yet fully experienced. That is the whole argument against compressing the schedule and it is a good one.

The reasoning is more useful than the number, which is why I have shown it.

Post #14 describes the usual case. This is about the unusual one.

The failure mode on steady state is boring rather than dramatic. It is almost always the step everyone assumes was done correctly because it is too simple to get wrong.

This follows post #17 rather than contradicting it.

I read the earlier replies on steady state twice before writing this, because I had assumed the opposite and wanted to be sure I was disagreeing with what was said rather than what I expected.

Nothing to add, except that this is the answer I would give if asked.

Post #19 is right about the mechanism and I think understates the practical bit.

For anyone finding this later: the short answer on steady state is that it depends on one thing, and the rest of the thread is people identifying which thing.

Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.

I read post #23 twice before replying, because I had assumed the opposite.

There is no published evidence about slower escalation because nobody studied it. That means the trials support not going faster and are silent on going slower, which is a different claim from "slower is fine".

That matches what I was told, which is not the same as knowing it.

Adding the boring version of steady state, because the interesting version keeps getting posted and the boring one is usually right.

Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does.

Before the thread moves on from steady state — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred.

Taking post #27 at face value and following it one step further.

Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.

Not the whole picture, but the part of it I can speak to.

The question underneath steady state is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.

Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.

This is the answer, and the reason it is the answer is the more useful part.