Determining the duration of antidepressant treatment: Application of signal detection methodology and the need for duration adaptive designs (DAD)
Determining the duration of antidepressant treatment: Application of signal detection methodology and the need for duration adaptive designs (DAD)
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DOI：
10.1016/j.biopsych.2005.08.033
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发表时间：
2006-03-15
影响因子：
10.6
通讯作者：
Lavori, PW
中科院分区：
文献类型：
--
作者：
Sackeim, HA;Roose, SP;Lavori, PW
背景：随着现在的治疗目标是缓解，抗抑郁药物的试验持续时间也增加了。然而，大多数患者不会缓解，并且会遭受长期无效的治疗。方法：在三项对照试验中，对晚年或中年抑郁症患者进行的为期 12 周的抗抑郁试验中早期检测非缓解者的条件概率和信号检测方法进行对比。结果：中年和晚年样本在缓解率或缓解时间或早期识别不缓解的准确性方面没有差异。使用条件概率，根据缓解标准，预测能力存在显着差异。通过信号检测方法，早期识别的敏感性和特异性在不同的药物条件、缓解标准和三项研究中是一致的。到第 6 周，>= 60% 的最终非汇款人被识别出来，同时保持假阳性率
Background: With remission now the treatment goal, antidepressant trial duration has increased. However, most patients do not remit and are exposed to prolonged, ineffective treatment.Methods: Conditional probabilities and signal detection methodology were contrasted in early detection of nonremitters in three comparator, 12-week antidepressant trials conducted in late- or mid-life, depression.Results: The mid- and late-life samples did not differ in rates or time-to-onset of remission or accuracy of early identification of nonremission. Using conditional probabilities, there were marked differences in predictive power depending on the remission criterion. With signal detection methods, sensitivity and specificity of early identification were uniform across the differing medication conditions, remission criteria, and the three studies. By week 6, >= 60% of ultimate nonremitters were identified, while maintaining a false positive rate