实例-Meta分析评述

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1、Meta-AnalysisCritiqueTheEfficacyofRelapsePreventiononSubstanceUseDisordersAshleeCarter11/7/05ReferenceIrvin,J.E.,Bowers,C.A.,Dunn,M.E.,&Wang,M.C.(1999).EfficacyofRelapsePrevention:AMeta-AnalyticReview.JournalofConsultingandClinicalPsychology,67,563-570.ResearchDomainClinicalPsycholog

2、yTherapeuticInterventionsSubstanceUseDisordersAlcoholUseCocaineUseSmoking(Tobacco)PolysubstanceUseCentralQuestionsWhatistheeffectofRPonsubstanceusebehaviorWhatistheeffectofRPonoverallpsychosocialadjustment?PotentialModeratingVariablesClassofsubstanceusedisorderTreatmentmodalitySettin

3、goftreatmentAdjunctiveuseofmedicationOutcomemeasuresComparativeefficacyofRPLengthofposttreatmentfollow-upMethodsStudyidentification:ComputerizeddatabasesReferencelistsContactprominentresearcherstorequestunpublisheddataInclusion/ExclusioncriteriaResult:26studies,70hypothesistests,9,50

4、4participantsMethodsMaineffectsizesconvertedtorMinimeta-analysiswithinstudiesrtransformedtoFisher’szWeightedaveragezscorecalculatedzconvertedbacktorAggregateracrossstudies95%CIcalculatedWeightedaveragerResultsOveralltreatmenteffectofRPinterventionsforalcoholusedisorders,substanceused

5、isorders,andsmokingisr=.14(95%CI=.10–.17,n=22).OveralltreatmenteffectofRPinterventionsonimprovingpsychosocialadjustmentisr=.48(95%CI=.42to.53,n=10).Results:Filedrawerbias?Fail-safen=388(p=0.05)NumberofundiscoveredstudiesaveragingnoeffectofRPinterventionsthatwouldberequiredtoreducethe

6、obtainedrelationshiptozeroConclusion:ThemaineffectistoleranttofutureundiscoverednullresultsResults:ModeratorAnalysisContrastanalysesZscoresProblems:SmallsamplesizesDifferencesineffectsizesduetoclassofsubstanceusedisorderMedicationvariesResults:ModeratingVariables1)Moreeffectiveintrea

7、tingalcoholandpolysubstanceusethansmokingorcocaineuse.2)Equallyeffectiveingroupandindividualformats.3)Equallyeffectiveinoutpatientandinpatientformats.4)Moreeffectivewithadjunctivemedicationthanwithout.5)Reportedmoreeffectiveinstudiesthatusedself-reportversusbiochemicallyvalidatedself

8、-reportmeasu