Most small children are flat-footed.
Background
Most small children are flat-footed. If flat-footedness persists past early childhood, it can lead to discomfort. Traditionally, flat-footed children wear special shoes that give extra support to foster development of an arch.
Implicit Conclusion
The traditional treatment is efficacious — wearing the special shoes promotes arch development.
Evaluate
The treatment counts as efficacious only if children who wear the shoes actually develop arches at a higher rate than they would without the shoes. If kids without the shoes develop arches at the same rate, the shoes aren't doing anything — the arch was going to develop anyway.
Goal
Find evidence that arch development happens just as often without the shoes — that's a direct hit on efficacy.