6 results
Search Results
2. Protocol for a randomized pilot study (FIRST STEPS): implementation of the Incredible Years-ASLD® program in Spanish children with autism and preterm children with communication and/or socialization difficulties
- Author
-
Fátima Valencia, Inmaculada Navas, Maria Elias, Laia Villalta, Marina Romero-González, Almudena Ramírez, Alexandra Garriz, Elena Urbiola, [Valencia,F, Urbiola,E, Garriz,A] Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Romero-González,M, Navas,I, Ramírez,A] Maternity Hospital, Hospital Regional Universitario de Málaga, Málaga, Spain. [Romero-González,M, Ramírez,A] Department of Brain Health, CIMES, Faculty of Medicine-IBIMA, UMA, Málaga, Spain. [Elías,M, Villalta,L] Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L’Hospitalet de Llobregat, Spain. [Villalta,L] Children and Adolescent Mental Health Research Group, Research Institute Sant Joan de Déu, Esplugues de Llobregat, Spain., and This paper reports on independent research financially supported by the Alicia Koplowitz Foundation.
- Subjects
Parents ,Medicine (General) ,Information Science::Information Science::Communication [Medical Subject Headings] ,Autism Spectrum Disorder ,Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Family::Family Relations::Parenting [Medical Subject Headings] ,Psychological intervention ,Medicine (miscellaneous) ,Pilot Projects ,law.invention ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Study Protocol ,0302 clinical medicine ,Randomized controlled trial ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Multicenter Studies as Topic [Medical Subject Headings] ,law ,Autistic children ,Medicine ,Multicenter Studies as Topic ,Pharmacology (medical) ,Child ,Child development ,Randomized Controlled Trials as Topic ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic [Medical Subject Headings] ,Parenting ,Communication ,05 social sciences ,Pilot ,Autism spectrum disorder ,Child, Preschool ,Premature Birth ,050104 developmental & child psychology ,Clinical psychology ,medicine.medical_specialty ,Parenting intervention ,Pilotos ,Psychiatry and Psychology::Mental Disorders::Mental Disorders Diagnosed in Childhood::Child Development Disorders, Pervasive::Autistic Disorder [Medical Subject Headings] ,ASD ,Desarrollo infantil ,03 medical and health sciences ,R5-920 ,Complex intervention ,Intervention (counseling) ,Humans ,0501 psychology and cognitive sciences ,Persons::Persons::Age Groups::Child [Medical Subject Headings] ,Autistic Disorder ,Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Pilot Projects [Medical Subject Headings] ,Infants autistes ,business.industry ,Public health ,Trastorno del espectro del autismo ,Socialization ,medicine.disease ,Mental health ,Responsabilidad parental ,Desenvolupament infantil ,Preterm children ,Spain ,randomized controlled trial ,Autism ,Anthropology, Education, Sociology and Social Phenomena::Social Sciences::Sociology::Socialization [Medical Subject Headings] ,Diseases::Female Urogenital Diseases and Pregnancy Complications::Pregnancy Complications::Obstetric Labor Complications::Obstetric Labor, Premature::Premature Birth [Medical Subject Headings] ,business ,Persons::Persons::Parents [Medical Subject Headings] ,Persons::Persons::Age Groups::Child::Child, Preschool [Medical Subject Headings] ,030217 neurology & neurosurgery ,Nacimiento prematuro - Abstract
Abstract Having access to parenting interventions in the early years is key to improve the developmental outcomes of children with neurodevelopmental problems. The Incredible Years® (IY) Parent Program is a group intervention that has demonstrated efficacy in terms of reducing stress in parents, as well as improving behavioral, emotional, and social outcomes in children. The program has been recently adapted for families of children with autism or language delays (IY-ASLD®). This intervention has not yet been implemented in the Spanish Public Health System, where there is a scarcity of evidence-based interventions being offered to families with young children presenting neurodevelopmental problems. The main aims of this study are to determine the feasibility of implementing the IY-ASLD® program within Spanish Child Mental Health Services and to examine parents’ acceptability and satisfaction with the intervention. As a secondary objective, we aim to evaluate its preliminary effectiveness in terms of reducing parental stress and behavioral difficulties in their children. The FIRST STEPS study is a multicenter, pilot randomized controlled trial comparing the IY-ASLD® program with a treatment-as-usual (TAU) condition. Approximately 70 families of children with autism spectrum disorder (ASD) and preterm children with communication and/or socialization difficulties (aged 2–5 years) will be recruited. Families will be assessed prior to randomization and after the intervention. Due to the COVID-19 pandemic, the intervention will consist of 22 weekly online sessions (approximately 6 months). The FIRST STEPS pilot trial will demonstrate the feasibility and acceptability of reliably implementing the IY-ASLD® program within the Spanish Public Health System. The results of this study could represent the first step to inform policymakers in Spain when designing evidence-based healthcare pathways for families of children presenting ASD symptoms or neurodevelopmental difficulties at early stages. Trial registration ClinicalTrials.gov NCT04358484. Registered on 04 April 2020
- Published
- 2021
3. Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study)
- Author
-
Carlos Suso-Ribera, Francesco D'Amico, Antonio Cuesta-Vargas, Juan P. Sanabria-Mazo, Antoni Sanz, Juan R. Castaño-Asins, Pere Estivill-Rodríguez, Paula Cristóbal-Narváez, Albert Feliu-Soler, Adrián Pérez-Aranda, Grasa Mm, Antonio Montes-Pérez, Azucena García-Palacios, Lance M. McCracken, Carlos G. Forero, Michael Maes, Araceli Rosa, Xavier Borrás, Juan V. Luciano, Ariadna Colomer-Carbonell, Bernat Carreras-Marcos, Laura Andrés-Rodríguez, Silvia Edo, Olga Comps-Vicente, Montserrat Esteve, This study has been funded by the Institute of Health Carlos III (ISCIII, and PI19/00112 & PI16/00165 have been cofinanced with European Union ERDF funds). JVL has a 'Miguel Servet Type II' contract from the ISCIII (CPII19/00003). ISCIII did not have any role in the analysis and interpretation of data, in the writing of the manuscript and in the decision to submit the paper for publication.
- Subjects
Technology ,General Practice ,lcsh:Medicine ,Impact study ,Chronic pain ,R Medicine (General) ,Acceptance and commitment therapy ,law.invention ,Clinical trials ,Randomized controlled trial ,Terapia de aceptación y compromiso ,law ,Depresión ,Tratamiento breve de activación conductual para la depresión ,Dolor persistente ,Persistent pain ,Medicine ,Multicenter Studies as Topic ,Depressió psíquica ,Depression (differential diagnoses) ,Applied Psychology ,Randomized Controlled Trials as Topic ,Ecology ,Depression ,Teràpia racional emotiva conductual ,General Medicine ,Dolor crònic ,Chronic low back pain ,Mental depression ,Rational emotive behavior therapy ,BF Psychology ,Ecological Momentary Assessment ,Clinical trials, Depression & mood disorders, pain management ,Brief behavioral activation treatment for depression ,159.9 ,Health Economics ,Dolor lumbar crónico ,Humans ,Tractament breu d’activació conductual per a la depressió ,Acceptance and Commitment Therapy ,Protocol (science) ,Dolor lumbar crònic ,business.industry ,lcsh:R ,Teràpia d’acceptació i compromís ,Dolor persistent ,Tillämpad psykologi ,Pain management ,Clinical trial ,Allmänmedicin ,pain management ,Spain ,Depression & mood disorders ,Economic evaluation ,Depressió ,business ,Low Back Pain - Abstract
IntroductionThe IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre–post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes.Methods and analysisParticipants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed.Ethics and disseminationThis study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities.Trial registration numberNCT04140838
- Published
- 2020
4. Randomised, double-blind, placebo-controlled clinical trial for evaluating the efficacy of intracoronary injection of autologous bone marrow mononuclear cells in the improvement of the ventricular function in patients with idiopathic dilated myocardiopathy: a study protocol
- Author
-
Miguel Romero, José Suárez-de-Lezo, Concha Herrera, Manuel Pan, José López-Aguilera, Flor Baeza-Garzón, Francisco Javier Hidalgo-Lesmes, Olga Fernández-López, Juliana Martínez-Atienza, Eva Cebrián, Vanesa Martín-Palanco, Rosario Jiménez-Moreno, Rosario Gutiérrez-Fernández, Sonia Nogueras, Maria Dolores Carmona, Soledad Ojeda, Natividad Cuende, Rosario Mata, [Romero,M, Suárez-de-Lezo, Pan,M, López-Aguilera,J, Suárez-de-Lezo Jr,J, Baeza-Garzón,F, Hidalgo-Lesmes,FJ, Cebrián,E, Ojeda,S] Cardiology Unit, Reina Sofía University Hospital, Córdoba, Spain. [Herrera,C, Martín-Palanco,V, Jiménez-Moreno,R, Gutiérrez-Fernández,R, Nogueras,S, Carmona,MD] Cell Production Unit, Reina Sofía University Hospital, Córdoba, Spain. [Fernández-López,O, Martínez-Atienza,J, Cuende,N, Mata,R] Andalusian Initiative for Advanced Therapies, Andalusian Public Foundation Progress and Health, Seville, Spain., and This paper presents an investigator-driven Clinical trial partially funded by research grant provided by the Regional Ministry of Health of Andalusia (Grant Reference Number salud-201600073587-tra).
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Time Factors ,Ensayo clínico controlado aleatorio ,030204 cardiovascular system & hematology ,Cell therapy ,Ventricular Function, Left ,law.invention ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Study Protocol ,Cardiomiopatía dilatada ,0302 clinical medicine ,Randomized controlled trial ,law ,Dilated myocardiopathy ,Multicenter Studies as Topic ,030212 general & internal medicine ,Myocardial infarction ,Diseases::Cardiovascular Diseases::Heart Diseases::Cardiomyopathies::Cardiomyopathy, Dilated [Medical Subject Headings] ,Bone Marrow Transplantation ,Randomized Controlled Trials as Topic ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Evaluation Studies as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic [Medical Subject Headings] ,Diseases::Cardiovascular Diseases::Vascular Diseases::Myocardial Ischemia::Myocardial Infarction [Medical Subject Headings] ,Ejection fraction ,Middle Aged ,Treatment Outcome ,Disciplines and Occupations::Natural Science Disciplines::Science::Research::Biomedical Research [Medical Subject Headings] ,Female ,Cardiology and Cardiovascular Medicine ,Adult ,Cardiomyopathy, Dilated ,medicine.medical_specialty ,Information Science::Information Science::Communications Media::Publications [Medical Subject Headings] ,Adolescent ,Cell- and tissue-based therapy ,Células de la médula ósea ,Bone Marrow Cells ,Placebo ,Transplantation, Autologous ,Young Adult ,03 medical and health sciences ,Clinical Trials, Phase II as Topic ,Double-Blind Method ,Tratamiento basado en trasplante de células y tejidos ,Internal medicine ,medicine ,Humans ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Cell- and Tissue-Based Therapy [Medical Subject Headings] ,Aged ,Angiology ,Anatomy::Cells::Bone Marrow Cells [Medical Subject Headings] ,business.industry ,Consolidated Standards of Reporting Trials ,Recovery of Function ,medicine.disease ,Interim analysis ,Clinical trial ,lcsh:RC666-701 ,Spain ,Bone marrow mononuclear cells ,business - Abstract
Cellular therapies have been increasingly applied to diverse human diseases. Intracoronary infusion of bone marrow-derived mononuclear cells (BMMNC) has demonstrated to improve ventricular function after acute myocardial infarction. However, less information is available about the role of BMMNC therapy for the treatment of dilated myocardiopathies (DCs) of non-ischemic origin. This article presents the methodological description of a study aimed at investigating the efficacy of intracoronary injection of autologous BMMNCs in the improvement of the ventricular function of patients with DC. This randomised, placebo-controlled, double-blinded phase IIb clinical trial compares the improvement on ventricular function (measured by the changes on the ejection fraction) of patients receiving the conventional treatment for DC in combination with a single dose of an intracoronary infusion of BMMNCs, with the functional recovery of patients receiving placebo plus conventional treatment. Patients assigned to both treatment groups are monitored for 24 months. This clinical trial is powered enough to detect a change in Left Ventricular Ejection Fraction (LVEF) equal to or greater than 9%, although an interim analysis is planned to re-calculate sample size. The study protocol was approved by the Andalusian Coordinating Ethics Committee for Biomedical Research (Comite Coordinador de Etica en Investigacion Biomedica de Andalucia), the Spanish Medicines and Medical Devices Agency (Agencia Espanola de Medicamentos y Productos Sanitarios), and is registered at the EU Clinical Trials Register (EudraCT: 2013–002015-98). The publication of the trial results in scientific journals will be performed in accordance with the applicable regulations and guidelines to clinical trials. ClinicalTrials.gov Identifier NCT02033278 (First Posted January 10, 2014): https://clinicaltrials.gov/ct2/show/NCT02033278 ; EudraCT number: 2013–002015-98, EU CT Register: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2013-002015-98 . Trial results will also be published according to the CONSORT statement at conferences and reported peer-reviewed journals.
- Published
- 2019
5. Incorporating individual historical controls and aggregate treatment effect estimates into a Bayesian survival trial: a simulation study
- Author
-
Lisa V. Hampson, Marie-Cécile Le Deley, Caroline Brard, Nathalie Gaspar, Gwénaël Le Teuff, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Statistical Methodology [Bâle, Suisse], Novartis Pharma AG, Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy], Institut Gustave Roussy (IGR), Unité de Méthodologie et de Biostatistique [Lille] (UMB), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER-Université de Lille-UNICANCER, We acknowledge for the design, analysis, interpretation of the simulation study, and for the writing of the manuscript, funding from – PhD grant from doctoral school of public health, Paris-Sud, Paris-Saclay – Lisa Hampson’s contribution to the paper was partly funded by the UK Medical Research Council (grant MR/M013510/1) and was completed while she was an employee of Lancaster University – Ligue contre le cancer, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Lille Nord de France (COMUE)-UNICANCER-Université Lille Nord de France (COMUE)-UNICANCER, and Bodescot, Myriam
- Subjects
Simulation study ,Epidemiology ,Computer science ,Bayesian probability ,Health Informatics ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Power prior ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Adjuvants, Immunologic ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Randomized controlled trial ,law ,Statistics ,Prior probability ,Humans ,Computer Simulation ,030212 general & internal medicine ,Set (psychology) ,Baseline (configuration management) ,Bayesian randomised survival trial ,Randomized Controlled Trials as Topic ,Weibull distribution ,Osteosarcoma ,lcsh:R5-920 ,Phosphatidylethanolamines ,030503 health policy & services ,Aggregate (data warehouse) ,Bayes Theorem ,Variance (accounting) ,Models, Theoretical ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,Control Groups ,Mixture prior ,3. Good health ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Research Design ,Sample Size ,Individual control data ,0305 other medical science ,lcsh:Medicine (General) ,Aggregate treatment effect ,Acetylmuramyl-Alanyl-Isoglutamine ,Rare disease ,Algorithms ,Research Article - Abstract
Background Performing well-powered randomised controlled trials (RCTs) of new treatments for rare diseases is often infeasible. However, with the increasing availability of historical data, incorporating existing information into trials with small sample sizes is appealing in order to increase the power. Bayesian approaches enable one to incorporate historical data into a trial’s analysis through a prior distribution. Methods Motivated by a RCT intended to evaluate the impact on event-free survival of mifamurtide in patients with osteosarcoma, we performed a simulation study to evaluate the impact on trial operating characteristics of incorporating historical individual control data and aggregate treatment effect estimates. We used power priors derived from historical individual control data for baseline parameters of Weibull and piecewise exponential models, while we used a mixture prior to summarise aggregate information obtained on the relative treatment effect. The impact of prior-data conflicts, both with respect to the parameters and survival models, was evaluated for a set of pre-specified weights assigned to the historical information in the prior distributions. Results The operating characteristics varied according to the weights assigned to each source of historical information, the variance of the informative and vague component of the mixture prior and the level of commensurability between the historical and new data. When historical and new controls follow different survival distributions, we did not observe any advantage of choosing a piecewise exponential model compared to a Weibull model for the new trial analysis. However, we think that it remains appealing given the uncertainty that will often surround the shape of the survival distribution of the new data. Conclusion In the setting of Sarcome-13 trial, and other similar studies in rare diseases, the gains in power and accuracy made possible by incorporating different types of historical information commensurate with the new trial data have to be balanced against the risk of biased estimates and a possible loss in power if data are not commensurate. The weights allocated to the historical data have to be carefully chosen based on this trade-off. Further simulation studies investigating methods for incorporating historical data are required to generalise the findings. Electronic supplementary material The online version of this article (10.1186/s12874-019-0714-z) contains supplementary material, which is available to authorized users.
- Published
- 2019
6. Improving study design for antidepressant effectiveness assessment
- Author
-
Naudet, Florian, Millet, Bruno, Reymann, Jean-Michel, Falissard, Bruno, Troubles du comportement alimentaire de l'adolescent (UMR_S 669), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Psychiatrie, Centre Hospitalier Guillaume Régnier, Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes], This paper was supported by the Institut National de la Santé et de la Recherche Médicale (INSERM)., Le Corre, Morgane, Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Troubles du comportement alimentaire de l'adolescent ( UMR_S 669 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Sud - Paris 11 ( UP11 ), Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Comportement et noyaux gris centraux [Rennes], Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Université européenne de Bretagne ( UEB ) -CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Pharmacologie, and Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR)
- Subjects
Depressive Disorder, Major ,clinical trials ,[SDV.SP.MED] Life Sciences [q-bio]/Pharmaceutical sciences/Medication ,Psychometrics ,[ SDV.MHEP.PSM ] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[ SDV.SP.MED ] Life Sciences [q-bio]/Pharmaceutical sciences/Medication ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Reproducibility of Results ,effectiveness ,methodology ,Original Articles ,Personality Assessment ,Antidepressive Agents ,Observational Studies as Topic ,Double-Blind Method ,[SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication ,Research Design ,Surveys and Questionnaires ,antidepressants ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Outcome Assessment, Health Care ,depression ,Humans ,Randomized Controlled Trials as Topic - Abstract
Antidepressants effectiveness in major depressive disorder (MDD) is still questioned because the extrapolation of randomized controlled trial (RCT) results to “real life” settings is problematic. The application of the RCT paradigm in a disorder of this type, where global care plays a central role, raises questions regarding the internal and external validity of this type of study. Outcome measurement, attrition rates, the ability of the double‐blind design to control for expectations, placebo response, the representativeness of trial participants and publication bias are major methodological pitfalls. This review discusses these issues. It is illustrated using original data and proposes some alternatives for assessing antidepressant effectiveness via different approaches. Some are easy to implement, such as ecological measures, qualitative approaches, improvement of analytical strategy and improvement of blinding procedures. Some are sophisticated, involving temporary deception to deal with the confounding effect of expectations, and they raise ethical issues. Others resort to external validity, this being the case in observational studies. But all are necessary to explore antidepressant effectiveness. Copyright © 2013 John Wiley & Sons, Ltd.
- Published
- 2013
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.