Systematic review and meta-analysis of Internet interventions for smoking cessation among adults.
Systematic review and meta-analysis of Internet interventions for smoking cessation among adults.
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DOI：
10.2147/sar.s101660
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发表时间：
2016
影响因子：
1.8
通讯作者：
Cole-Lewis H
中科院分区：
文献类型：
--
作者：
Graham AL;Carpenter KM;Cha S;Cole S;Jacobs MA;Raskob M;Cole-Lewis H
本系统综述的目的是确定相对于治疗指南中推荐的其他形式的干预，互联网干预在促进成年烟草使用者戒烟方面的有效性。本综述遵循Cochrane Collaboration的系统综述指南。“互联网”、“基于网络”和“戒烟干预”以及相关关键词的组合在自动和手动搜索中都被使用。我们纳入了1990年1月至2015年4月发表的随机试验。采用改良版Cochrane偏倚风险评估工具。我们计算了每项研究的风险比（rr）。采用随机效应法进行meta分析，汇总rr。结果的呈现遵循PRISMA（系统评价和荟萃分析的首选报告项目）指南。纳入了40项随机试验，涉及98,530名参与者。大多数试验在大多数领域的偏倚风险较低。将互联网干预与仅评估/等候名单对照进行比较的汇总结果具有显著性（RR 1.60, 95%可信区间[CI] 1.15-2.21, I2=51.7%； 4项研究）。与印刷材料相比，大部分静态互联网干预的汇总结果不显著（RR 0.83, 95% CI 0.63-1.10, I2=0%，两项研究），而交互式互联网干预与印刷材料的比较具有显著性（RR 2.10, 95% CI 1.25-3.52, I2=41.6%，两项研究）。与面对面咨询（RR 1.35, 95% CI 0.97-1.87, I2=0%， 4项研究）或电话咨询（RR 0.95, 95% CI 0.79-1.13, I2=0%， 2项研究）相比，网络干预的综合结果未观察到显著影响。大多数试验比较了不同的互联网干预措施；来自15个这样的试验（24个比较）的汇总结果发现，实验性互联网干预有显著效果（RR 1.16, 95% CI 1.03-1.31, I2=76.7%）。互联网干预措施优于其他广泛的戒烟干预措施（即印刷材料），相当于其他目前推荐的治疗模式（电话和面对面咨询），并且它们在烟草依赖治疗的“武器库”中可发挥重要作用。
The aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines. This review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of “Internet,” “web-based,” and “smoking cessation intervention” and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs) for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Forty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15–2.21, I2=51.7%; four studies). Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63–1.10, I2=0%; two studies), whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25–3.52, I2=41.6%; two studies). No significant effects were observed in pooled results of Internet interventions compared to face-to-face counseling (RR 1.35, 95% CI 0.97–1.87, I2=0%; four studies) or to telephone counseling (RR 0.95, 95% CI 0.79–1.13, I2=0%; two studies). The majority of trials compared different Internet interventions; pooled results from 15 such trials (24 comparisons) found a significant effect in favor of experimental Internet interventions (RR 1.16, 95% CI 1.03–1.31, I2=76.7%). Internet interventions are superior to other broad reach cessation interventions (ie, print materials), equivalent to other currently recommended treatment modes (telephone and in-person counseling), and they have an important role to play in the arsenal of tobacco-dependence treatments.