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Nutricion Hospitalaria Aug 2022
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Eye (London, England) Apr 2022
Topics: Humans; Meta-Analysis as Topic
PubMed: 34987196
DOI: 10.1038/s41433-021-01867-6 -
BMJ Open Mar 2022It is unclear how pharmacological and non-pharmacological interventions compare with each other in terms of efficacy and tolerability for core symptoms and additional...
INTRODUCTION
It is unclear how pharmacological and non-pharmacological interventions compare with each other in terms of efficacy and tolerability for core symptoms and additional problems in adults with attention-deficit/hyperactivity disorder (ADHD). We aim to conduct the first network meta-analysis (NMA) comparing pharmacological and non-pharmacological interventions (or their combinations) in adults with ADHD.
METHODS AND ANALYSIS
We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for NMAs. We will search a broad set of electronic databases/registries and contact drug companies and experts in the field to retrieve published and unpublished randomised controlled trials (RCTs) (parallel or cross-over) of medications (either licensed or unlicensed) and any non-pharmacological intervention in adults (≥18 years) with ADHD. Primary outcomes will be: (1) change in severity of ADHD core symptoms, and (2) acceptability (all-cause discontinuation). Secondary outcomes will include tolerability (drop-out due to side effects) and change in the severity of emotional dysregulation, executive dysfunctions and quality of life. The risk of bias in each individual RCT included in the NMA will be assessed using the Cochrane Risk of Bias tool-version 2. We will evaluate the transitivity assumption comparing the distribution of possible effect modifiers across treatment comparisons. We will perform Bayesian NMA for each outcome with random-effects model in OpenBUGS. Pooled estimates of NMA will be obtained using the Markov Chains Monte Carlo method. We will judge the credibility in the evidence derived from the NMA using the CINeMA tool (which includes assessment of publication bias). We will conduct a series of sensitivity analyses to assess the robustness of the findings.
ETHICS AND DISSEMINATION
As this is the protocol for an aggregate-data level NMA, ethical approval will not be required. Results will be disseminated at national/international conferences and in peer-reviewed journals.
PROSPERO REGISTRATION NUMBER
CRD42021265576.
Topics: Adult; Attention Deficit Disorder with Hyperactivity; Humans; Meta-Analysis as Topic; Network Meta-Analysis; Quality of Life; Systematic Reviews as Topic
PubMed: 35277411
DOI: 10.1136/bmjopen-2021-058102 -
Journal of Cachexia, Sarcopenia and... Jun 2018
Topics: Humans; Meta-Analysis as Topic; Systematic Reviews as Topic
PubMed: 29873945
DOI: 10.1002/jcsm.12312 -
Epidemiology and Health 2019The objective of this study was to describe general approaches for intervention meta-analysis available for quantitative data synthesis using the R software. We...
The objective of this study was to describe general approaches for intervention meta-analysis available for quantitative data synthesis using the R software. We conducted an intervention meta-analysis using two types of data, continuous and binary, characterized by mean difference and odds ratio, respectively. The package commands for the R software were "metacont", "metabin", and "metagen" for the overall effect size, "forest" for forest plot, "metareg" for meta-regression analysis, and "funnel" and "metabias" for the publication bias. The estimated overall effect sizes, test for heterogeneity and moderator effect, and the publication bias were reported using the R software. In particular, the authors indicated methods for calculating the effect sizes of the target studies in intervention meta-analysis. This study focused on the practical methods of intervention meta-analysis, rather than the theoretical concepts, for researchers with no major in statistics. Through this study, the authors hope that many researchers will use the R software to more readily perform the intervention meta-analysis and that this will in turn generate further related research.
Topics: Humans; Meta-Analysis as Topic; Research Design; Software
PubMed: 30999738
DOI: 10.4178/epih.e2019008 -
Acta Psychiatrica Scandinavica Feb 2022Meta-analytic reviews suggest similar outcomes across trauma-focused psychotherapies for adults with post-traumatic stress disorder (PTSD). However, this conclusion may... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Meta-analytic reviews suggest similar outcomes across trauma-focused psychotherapies for adults with post-traumatic stress disorder (PTSD). However, this conclusion may be premature due to suboptimal statistical-review methodologies. Network meta-analysis (NMA) allows a detailed rank-ordering of the efficacy of established psychotherapy interventions derived from indirect evidence as well as results from direct head-to-head comparisons.
OBJECTIVE
We sought to determine the efficacy and attrition rates of psychotherapy interventions for PTSD by applying NMA.
METHODS
We searched EMBASE, PsychINFO, PTSDPubs and PubMed for randomised controlled trials that compared psychotherapies either head-to-head or against controls for adults with PTSD. A frequentist NMA was used to compare direct and indirect effects to determine the efficacy and attrition rates of psychotherapy interventions.
RESULTS
Of the 5649 papers identified, 82 trials comprising of 5838 patients were included. The network comprised 17 psychotherapies and four control conditions. Network estimates indicated superior efficacy of meta-cognitive therapy and cognitive processing therapy over other psychotherapies (ESs between = 0.26 and 2.32). Written exposure therapy and narrative exposure therapy were associated with lower risk of drop out when considered alongside other psychotherapies. Confidence in the network meta-analytic estimates was considered moderate for both outcomes.
CONCLUSIONS
In broad terms, therapeutic commensurability was evident. Nevertheless, with additional studies and larger sample sizes, meta-cognitive and written exposure therapies could indeed differentiate themselves from other approaches as having favourable efficacy and acceptability respectively. These findings may inform clinical decision-making, as well as guide future research for PTSD.
Topics: Adult; Cognitive Behavioral Therapy; Humans; Network Meta-Analysis; Psychotherapy; Stress Disorders, Post-Traumatic
PubMed: 34473342
DOI: 10.1111/acps.13366 -
Evidence-based Mental Health Aug 2019In most, if not all, healthcare conditions, there is a plethora of competing interventions with few head-to-head comparisons and classical meta-analysis fails to handle...
In most, if not all, healthcare conditions, there is a plethora of competing interventions with few head-to-head comparisons and classical meta-analysis fails to handle simultaneously the multiple comparisons among interventions. Network meta-analysis is an extension of pairwise meta-analysis to accommodate multiple interventions and comparisons.
Topics: Humans; Meta-Analysis as Topic; Network Meta-Analysis; Statistics as Topic
PubMed: 31302611
DOI: 10.1136/ebmental-2019-300104 -
Behavior Research Methods Jun 2023Network meta-analysis (NMA) allows the combination of evidence on the effectiveness of several interventions. NMA has mainly been applied in the medical science field,... (Meta-Analysis)
Meta-Analysis
Network meta-analysis (NMA) allows the combination of evidence on the effectiveness of several interventions. NMA has mainly been applied in the medical science field, whereas in the domain of psychology and educational sciences its use is less frequent. Consequently, systematic reviews that describe the characteristics of published NMAs are limited to the field of medicine, and nothing is known about the characteristics of NMAs published in the psychology and educational sciences field. However, this information is still relevant for the design of future simulation studies and for detecting good and bad research practices. Thus, this study describes the features of the meta-analytic datasets of NMAs published in the field of psychology and educational sciences, as well as their methodological characteristics, and compares them to those observed in the medical domain. Results show that the number of studies included is larger in NMAs from psychology and educational sciences, the most commonly used effect size is the standardized mean difference (unlike the odds ratio in medicine), the sample size is smaller, more intervention groups are included, and inconsistent effects are observed more often. These results can be used in future simulation studies to generate realistic datasets. Finally, we warn about the poor quality of reporting of some technical aspects of the NMA, such as the statistical model used.
Topics: Humans; Network Meta-Analysis; Sample Size; Forecasting
PubMed: 35821493
DOI: 10.3758/s13428-022-01905-5 -
BMJ (Clinical Research Ed.) Nov 1997
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JAMA Network Open Aug 2022
Topics: Humans; Meta-Analysis as Topic
PubMed: 36001322
DOI: 10.1001/jamanetworkopen.2022.28541