Efficacy of psychosocial interventions in cancer care: Evidence is weaker than it first looks
Efficacy of psychosocial interventions in cancer care: Evidence is weaker than it first looks
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DOI：
10.1207/s15324796abm3202_5
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发表时间：
2006-01-01
影响因子：
3.8
通讯作者：
Palmer, Steven C.
中科院分区：
文献类型：
--
作者：
Coyne, James C.;Lepore, Stephen J.;Palmer, Steven C.
随着越来越复杂，连续的审查发现较弱的证据，心理干预，以减少癌症患者的痛苦的疗效。然而，这些评价可能仍然过于积极，因为审查员不加批判地接受了这些试验的设计、分析和结果报告中的缺陷。使用来自高影响力期刊的随机试验，我们显示了验证性偏倚，选择性报告多个结局指标中最有利的，在随后的试验引用中抑制无效结果，以及删除最不可能从干预中受益的患者的数据。当考虑到文献中的这些地方性问题时，典型的癌症患者不会从干预措施中受益以减少痛苦的结论得到了加强。要求注册临床试验的细节和遵守CONSORT减少但不能消除文献中的偏倚。
With increasing sophistication, successive reviews find weaker evidence for the efficacy of psychosocial interventions to reduce distress among cancer patients. However, these appraisals may still be overly positive because of reviewers' uncritical acceptance of flaws in the design, analysis, and reporting of the results of such trials. Using randomized trials from high-impact journals, we show confirmatory bias, selective reporting of the most favorable of multiple outcome measures, suppressing of null results in subsequent citations of trials, and dropping of data for patients least likely to benefit from intervention. The conclusion that typical cancer patients do not benefit from interventions to reduce distress is strengthened when these endemic problems with the literature are taken into account. Required registering of the details of clinical trials and adherence to CONSORT reduces but does not eliminate bias in the literature.