Mediators and moderators of treatment effects in randomized clinical trials
Mediators and moderators of treatment effects in randomized clinical trials
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DOI：
10.1001/archpsyc.59.10.877
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发表时间：
2002-10-01
影响因子：
--
通讯作者：
Agras, WS
中科院分区：
文献类型：
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作者：
Kraemer, HC;Wilson, GT;Agras, WS
随机临床试验（RCTs）不仅是评估精神病学治疗效果的金标准，而且在揭示治疗改变的调节因子和中介因子方面也具有重要价值。从概念上讲，调节者确定治疗对谁以及在什么情况下产生不同的影响。调解员确定治疗产生效果的原因和方式。我们描述了一个分析框架来识别和区分随机对照试验中的调节因子和中介因子，当结果被测量维度时。在确定最有效的治疗方法以及了解哪些治疗有效和无效以及治疗为何有效或无效方面取得的快速进展，取决于确定治疗结果的调节因子和中介因子的努力。我们建议随机对照试验常规纳入并报告此类分析。
Randomized clinical trials (RCTs) not only are the gold standard for evaluating the efficacy and effectiveness of psychiatric treatments but also can be valuable in revealing moderators and mediators of therapeutic change. Conceptually, moderators identify on whom and under what circumstances treatments have different effects. Mediators identify why and how treatments have effects. We describe an analytic framework to identify and distinguish between moderators and mediators in RCTs when outcomes are measured dimensionally. Rapid progress in identifying the most effective treatments and understanding on whom treatments work and do not work and why treatments work or do not work depends on efforts to identify moderators and mediators of treatment outcome. We recommend that RCTs routinely include and report such analyses.