Using Clinical Trials to Benchmark Effects Produced in Clinical Practice

Minami, Takuya; Serlin, Ronald C.; Wampold, Bruce E.; Kircher, John C.; Brown, G. S.

doi:10.1007/s11135-006-9057-z

Cited by 87 publications

(123 citation statements)

References 18 publications

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“…Between-group differences were estimated, both in terms of mean and adjusted PHQ-9 change scores and as standardized effect sizes (Cohen's d). Within-group effect sizes were also calculated using the method proposed by Minami, Serlin, Wampold, Kircher, and Brown (2008); this estimate is comparable to Cohen's d, computed for repeated measures and weighted by sample size.…”

Section: Secondary Analysesmentioning

confidence: 99%

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Delgadillo

Gore²,

Ali

et al. 2015

Journal of Substance Abuse Treatment

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Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n = 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n = 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24 weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio = 7.14, p = .04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p = .59) or in PDA (p = .08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups.

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Section: Secondary Analysesmentioning

confidence: 99%

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Delgadillo

Gore²,

Ali

et al. 2015

Journal of Substance Abuse Treatment

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“…As suggested by Minami et al (2008), the initial SD was used for standardization rather than a pooled SD. ESs are presented as Cohen's d (Cohen, 1988) computed for repeated measures and adjusted for the pre-post measure correlation.…”

Section: Outcomes Effect Size Calculationmentioning

confidence: 99%

Measuring outcomes in outpatient child psychiatry: Reliable improvement, deterioration, and clinically significant improvement

Murphy

Blais

Baer

et al. 2013

Clin Child Psychol Psychiatry

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Given the increasing interest in demonstrating effectiveness in psychiatric treatment, the current paper seeks to advance outcome measurement in child psychiatry by demonstrating how more informative analytic strategies can be used to evaluate treatment in a real world setting using a brief, standardized parent-report measure. Questionnaires were obtained at intake for 1294 patients. Of these, 695 patients entered treatment and 531 (74%) had complete forms at intake and follow-up. Using this sample, we analyzed the data to determine effect sizes, rates of reliable improvement and deterioration, and rates of clinically significant improvement. Findings highlighted the utility of these approaches for evaluating treatment outcomes. Further suggestions for improving outcome measurement and evaluation are provided.

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“…They can be compared across studies using meta-analysis, they are helpful for benchmarking the effectiveness of routine interventions, they can be easily interpreted using conventional definitions of small, moderate and large effects, they can inform sample size calculations for future studies, etc. (Minami et al, 2008;Cohen, 1998).…”

Section: Discussionmentioning

confidence: 99%

Depression and anxiety symptoms: measuring reliable change in alcohol and drug users

Delgadillo

2012

Advances in Dual Diagnosis

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Purpose -This study aims to describe and to compare the reliability and accuracy of different methods of measuring psychiatric symptom changes in the context of substance use. Design/methodology/approach -A group of 60 patients in routine methadone treatment were followed-up during a ''watchful wait'' period of four to six weeks. Diagnoses of common mental disorders meeting International Classification of Diseases (ICD-10) criteria were established using the CIS-R structured diagnostic interview. Brief questionnaires for depression (PHQ-9) and anxiety (GAD-7) were used to measure symptom changes between test and retest. It was hypothesised that the accuracy of symptom changes measured using brief questionnaires may be compromised by methodological artefacts such as poor specificity, regression to the mean and measurement error. These assumptions were tested empirically.Findings -It was demonstrated that measuring change using conventional cut-offs in brief symptom questionnaires tends to overestimate the prevalence of common mental disorders and the rates of improvement. Using higher cut-off scores calibrated in samples of alcohol and drug users, in combination with a reliable change index results in more conservative and reliable estimates of symptom change.Originality/value -This paper presents a considered discussion on the relative merits and limitations of alternative psychiatric symptom measurement methods. These methodological recommendations may be of interest to research and clinical practice concerned with evaluating changes in comorbid depression and anxiety. Important questions are also raised about the modest degree of symptom changes typically observed during a watchful wait period.

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Using Clinical Trials to Benchmark Effects Produced in Clinical Practice

Abstract: benchmarking, efficacy and effectiveness, meta-analysis, psychotherapy, clinical practice,

Cited by 87 publications

References 18 publications

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Measuring outcomes in outpatient child psychiatry: Reliable improvement, deterioration, and clinically significant improvement

Depression and anxiety symptoms: measuring reliable change in alcohol and drug users

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