Differential attrition in health behaviour change trials: A systematic review and meta-analysis
Differential attrition in health behaviour change trials: A systematic review and meta-analysis
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DOI：
10.1080/08870446.2014.953526
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发表时间：
2015-01-02
影响因子：
3.3
通讯作者：
Kotz, Daniel
中科院分区：
文献类型：
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作者：
Crutzen, Rik;Viechtbauer, Wolfgang;Kotz, Daniel
目的：自然减员是健康行为改变（HBC）试验中的一个常见问题。当治疗条件之间的磨损程度不同时，这称为差异磨损，并被视为对内部有效性的主要威胁。本研究的主要研究问题是：HBC 试验中差异性磨损发生的频率和程度如何？设计：对随机选择的 HBC 试验 (k=60) 进行系统评价和荟萃分析。我们使用随机效应模型对相对减员率进行了荟萃分析，并检查了相对减员率与潜在调节因素之间的关系：分娩时的人际接触量和干预/控制条件的强度、控制条件的类型以及随访强度和持续时间。主要结果指标：相对减员率。结果：干预中的平均减员率为 18%（SD=.15；M=.15），平均减员率为 17%。 （SD=.13；M=.13）在控制条件下。估计平均相对流失率为 1.10（95% CI：1.01-1.20，p=0.02），表明干预条件下总体流失率为 10%。该相对流失率与任何潜在调节因素均无关。结论：有迹象表明，HBC 试验的干预条件下平均流失量略高。
Objective: Attrition is a common problem in health behaviour change (HBC) trials. When the degree of attrition differs between treatment conditions, then this is called differential attrition and is regarded as a major threat to internal validity. The primary research question of this study was: how often and to what degree does differential attrition occur in HBC trials?Design: A systematic review and meta-analysis of a random selection of HBC trials (k=60). We meta-analysed the relative attrition rates using a random-effects model and examined the relationship between the relative attrition rates and the potential moderators: the amount of human contact in delivery and the intensity of the intervention/control condition, the type of control condition, and the follow-up intensity and duration.Main outcome measures: Relative attrition rates.Results: The average attrition rate was 18% (SD=.15; M=.15) in the intervention and 17% (SD=.13; M=.13) in the control conditions. The estimated average relative attrition rate was 1.10 (95% CI: 1.01-1.20, p=.02), suggesting an overall higher attrition rate of 10% in the intervention conditions. This relative attrition rate was not related to any of the potential moderators.Conclusion: There is indication of a slightly higher amount of attrition on average in the intervention conditions of HBC trials.