Regression to the mean in substance use disorder treatment research
Regression to the mean in substance use disorder treatment research
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DOI：
10.1111/j.1360-0443.2007.02032.x
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发表时间：
2008-01-01
期刊：
影响因子：
6
通讯作者：
Finney, John W.
中科院分区：
文献类型：
--
作者：
Finney, John W.
AIMS回归到平均值(RTM)是指当重新评估两个点的分数不完全相关时，一组与总体平均值不同的病例向平均值移动(回归)的趋势。本文考虑了影响RTM大小的因素，以及RTM如何影响物质使用障碍(SUD)治疗的初步研究和综述的结果。设计与方法本论文主要以Campbell和Kenny的《回归伪影入门》为指导。它综述了在三个SUD治疗研究领域中潜在的RTM效应。一个是组内比较治疗试验的改善程度，包括“安慰剂效应”，是RTM的一个功能。第二个问题是采用非等价对照组设计的治疗评估对RTM的脆弱性，以及在匹配时对治疗效果的有偏估计，或使用统计等值来调整先前存在的组差异。最后一个问题是RTM在综合有关SUD治疗的研究结果方面的影响。特别是，与早期研究相比，特定干预的后期研究具有较小的治疗效果大小的趋势被认为是RTM现象。结果RTM是一种普遍但通常未被认识到的现象，它可能会对SUD治疗研究和该研究的系统评价中的结果产生偏见。结论SUD治疗研究人员应提高对RTM的认识，采取一切可能的措施减少RTM，并尝试诊断它是否仍在影响研究结果。
Aims Regression to the mean (RTM) refers to the tendency for a group of cases that differ from the population mean to move (regress) towards the mean, on average, when re-assessed, if scores at the two points are less than perfectly correlated. This paper considers factors that affect the magnitude of RTM and how RTM may impact findings from primary studies and reviews of substance use disorder (SUD) treatment. Design and methods The paper is guided largely by A Primer on Regression Artifacts by Campbell and Kenny. It reviews potential RTM effects in three areas of SUD treatment research. One is the extent to which within-group improvement in comparative treatment trials, including 'placebo effects', is a function of RTM. The second is the vulnerability of treatment evaluations employing non-equivalent control group designs to RTM and biased estimates of treatment effects when matching, or statistical equating is used to adjust for pre-existing group differences. The final issue is the impact of RTM in syntheses of research findings on SUD treatments. In particular, the tendency for later studies of a particular intervention to have smaller treatment effect sizes relative to earlier studies is considered as an RTM phenomenon. Findings RTM is a pervasive, but often unrecognized phenomenon that can bias findings in SUD treatment studies and in systematic reviews of that research. Conclusion SUD treatment researchers should be aware of RTM, take any available steps to reduce it, and try to diagnose whether it is still affecting research findings.