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Attrition in trials evaluating complex interventions for schizophrenia: Systematic review and meta-analysis
P Szymczynska1, S Walsh1, L Greenberg2
1Unit for Social and Community Psychiatry, Newham Centre for Mental Health, Queen Mary University of London, E13 8SP, UK.
Journal of Psychiatric Research
|February 24, 2017
Summary
This study analyzed drop-out rates in non-pharmacological schizophrenia trials. Results show overall intervention drop-out at 14% and study drop-out at 20%, indicating achievable lower rates.
Area of Science:
- Psychiatry
- Clinical Psychology
- Evidence-Based Medicine
Background:
- Methodological quality of randomized controlled trials (RCTs) is crucial.
- Drop-out rates significantly impact trial validity and reliability.
- Assessing drop-out in non-pharmacological schizophrenia trials is essential.
Purpose of the Study:
- To systematically review and meta-analyze drop-out rates in non-pharmacological schizophrenia trials.
- To determine overall intervention and study drop-out rates.
- To explore factors influencing drop-out rates.
Main Methods:
- Systematic literature search for relevant RCTs (sample size ≥100).
- Meta-analysis of proportions to calculate drop-out rates.
- Meta-regression to identify predictors of drop-out.
Main Results:
- 43 RCTs were included, with wide ranges in drop-out rates.
- Overall intervention drop-out rate was 14% (95% CI: 13-15%).
- Overall study drop-out rate was 20% (95% CI: 17-24%).
- Number of intervention sessions predicted intervention drop-out.
Conclusions:
- Non-pharmacological schizophrenia trials can achieve drop-out rates below 20%.
- High heterogeneity suggests potential for even lower drop-out rates.
- Minimizing drop-out is feasible and important for trial integrity.
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