结合终点和变化数据并没有影响对照和网络元分析中的总结标准化平均差异:抑郁症的经验研究
Edoardo G Ostinelli1,2,3, Orestis Efthimiou1,4,5, Yan Luo6
1Department of Psychiatry, University of Oxford, Oxford, UK.
Research synthesis methods
|May 9, 2024
概括
抑郁症严重程度的元分析可以结合终点和标准化平均差异 (SMD) 的变化得分. 这些分数之间的选择对药物和互联网提供的认知行为疗法干预措施的整体元分析结果的影响最小.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 生物统计学 生物统计学
- 证据综合 证据综合
背景情况:
- 分析需要标准化平均差异 (SMD),当研究使用多种规模来获得连续结果时.
- 结果经常被报告为终点或基线变化得分,这给结合SMD带来了挑战.
研究的目的:
- 调查结合终点和从基线变化的SMDs在抑郁症严重程度的元分析中的影响.
- 使用终点,基线变化或混合数据来比较特定研究和聚合的SMD.
主要方法:
- 利用来自89项药理学研究 (27,409名参与者) 和61项通过互联网提供的认知行为疗法 (iCBT) 研究 (13,687名参与者) 的个人参与者数据来治疗抑郁症.
- 从终点和基线变化得分计算研究特定的SMD.
- 使用不同组合的SMD进行了对对和网络元分析.
主要成果:
- 研究特定的SMD在很大程度上是相似的,在3个月后25%的ICBT研究中存在显著差异,特别是在具有基线不平衡的较小试验中.
- 在两种干预类型中,终点和变化SMD之间的聚合差异是可以忽略不计的.
- 仅将更有利的SMD放在一起并没有显著改变元分析估计,聚合的SMD差异高达0.05的药理和0.13的ICBT.
结论:
- 评估SMD的终点与变化得分的选择对抑郁症的总结元分析估计有无关紧要的影响.
- 研究结果支持在抑郁症的元分析中使用任何一种得分类型,简化了数据合成.
- 建议进行进一步的研究,以验证这些发现在其他治疗领域的有效性.
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