Toward the Design of Evidence-Based Mental Health Information Systems for People With Depression: A Systematic Literature Review and Meta-Analysis.
Toward the Design of Evidence-Based Mental Health Information Systems for People With Depression: A Systematic Literature Review and Meta-Analysis.
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DOI：
10.2196/jmir.7381
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发表时间：
2017-05-31
影响因子：
7.4
通讯作者：
Fleisch, Elgar
中科院分区：
文献类型：
--
作者：
Wahle, Fabian;Bollhalder, Lea;Fleisch, Elgar
背景：现有的研究假设了各种成分对技术中介的精神健康信息系统(MHIS)的利用和治疗结果产生影响。尽管研究人员评估了孤立的设计元素对基于网络的干预结果的影响，以及减轻症状与跨计算机和移动电话平台使用组件之间的关联，但仍不确定技术中介心理健康干预的哪些组件发挥了最大的治疗收益。到目前为止，还没有关于技术介导的MHIS治疗抑郁症的特定服务成分的治疗益处的研究结果。目的：本系统综述旨在确定技术介导的MHIS治疗抑郁症患者的成分。结果，对所有随机对照试验进行了综述，这些试验将技术中介的抑郁症治疗与等待名单对照、常规治疗或任何其他形式的抑郁症治疗进行比较。这项研究更新了以往的综述，旨在(1)评估技术支持的抑郁症干预措施的有效性，(2)增加关于技术介导的MHIS中哪些成分应该作为治疗抑郁症的标准的争论。方法：系统地搜索MEDLINE、QicINFO和Cochrane图书馆。使用标准平均差(SMD)计算技术启用的干预措施和对照条件之间的每次比较的效果大小。异质性检验采用卡方检验。采用亚群分析方法，分析了潜在的异质性来源。通过对漏斗图的目测和贝格检验来检验发表偏倚。定性的数据分析也被使用了。结果：在最初确定的6387项研究中，45项符合所有纳入标准。分析的方案显示抑郁症状显著减少(SMD-0.58，95%CI-0.71至-0.45，P
BACKGROUND: Existing research postulates a variety of components that show an impact on utilization of technology-mediated mental health information systems (MHIS) and treatment outcome. Although researchers assessed the effect of isolated design elements on the results of Web-based interventions and the associations between symptom reduction and use of components across computer and mobile phone platforms, there remains uncertainty with regard to which components of technology-mediated interventions for mental health exert the greatest therapeutic gain. Until now, no studies have presented results on the therapeutic benefit associated with specific service components of technology-mediated MHIS for depression.OBJECTIVE: This systematic review aims at identifying components of technology-mediated MHIS for patients with depression. Consequently, all randomized controlled trials comparing technology-mediated treatments for depression to either waiting-list control, treatment as usual, or any other form of treatment for depression were reviewed. Updating prior reviews, this study aims to (1) assess the effectiveness of technology-supported interventions for the treatment of depression and (2) add to the debate on what components in technology-mediated MHIS for the treatment of depression should be standard of care.METHODS: Systematic searches in MEDLINE, PsycINFO, and the Cochrane Library were conducted. Effect sizes for each comparison between a technology-enabled intervention and a control condition were computed using the standard mean difference (SMD). Chi-square tests were used to test for heterogeneity. Using subgroup analysis, potential sources of heterogeneity were analyzed. Publication bias was examined using visual inspection of funnel plots and Begg's test. Qualitative data analysis was also used. In an explorative approach, a list of relevant components was extracted from the body of literature by consensus between two researchers.RESULTS: Of 6387 studies initially identified, 45 met all inclusion criteria. Programs analyzed showed a significant trend toward reduced depressive symptoms (SMD -0.58, 95% CI -0.71 to -0.45, P