The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials.
The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials.
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DOI：
10.1177/1745691620968771
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Davidson RJ
中科院分区：
文献类型：
--
作者：
Goldberg SB;Riordan KM;Sun S;Davidson RJ
为了回答有关正念干预（MBIs）的科学基础的问题，我们通过系统地回顾随机对照试验（RCT）的荟萃分析来评估其经验状态。我们基于≥4项未结合联合收割机被动和主动对照的试验，检索了6个数据库的效应量。还提取了异质性、主持人、发表偏倚检验、偏倚风险和不良反应。在广泛的人群、问题、干预、比较和结局（PICOS）中，确定了基于最大数量研究的代表性效应量。在44项荟萃分析（k=336项RCT，N= 30，483名受试者）中，共报告了160个效应量。在大多数PICOS中，MBI显示出优于被动对照（ds=0.10-0.89）。与活性对照相比，效应通常较小，且不太具有统计学显著性。MBIs与特定的活性对照和循证治疗相似或上级。杂合性通常为中度。很少有一致的主持人被发现。结果一般是强大的出版偏见，虽然其他重要来源的偏见被确定。不良反应的报告不一致。荟萃分析可能缺乏统计学把握度，尤其是与活性对照的比较。由于MBI在一些PICOS中显示出希望，未来的随机对照试验和荟萃分析应建立在该文献已确定的优势和局限性的基础上。
In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on ≥4 trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k=336 RCTs, N=30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds=0.10–0.89). Effects were typically smaller and less often statistically significant when compared to active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. As MBIs show promise across some PICOS, future RCTs and meta-analyses should build upon identified strengths and limitations of this literature.
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