Predicting response to cognitive training for schizophrenia using results from two studies with different outcomes.
Predicting response to cognitive training for schizophrenia using results from two studies with different outcomes.
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DOI：
10.1016/j.schres.2021.03.006
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发表时间：
2021-05
影响因子：
4.5
通讯作者：
Medalia A
中科院分区：
文献类型：
--
作者：
Saperstein AM;Choi CJ;Jahshan C;Lynch DA;Wall M;Green MF;Medalia A
研究小组之间的协作数据共享提供了一个机会来探索精神分裂症文献中报道的认知训练结果异质性的基础。当前的分析侧重于场地和参与者特征对这些异质结果的贡献。将纽约 (NY) 和洛杉矶 (LA) 两项独立研究的数据合并起来，得到了 132 名患有精神分裂症/分裂情感障碍的门诊成人样本。虽然使用了相似的治疗剂量、认知练习和结果测量，但不同地点在辅导、小组讨论和补偿方面有所不同。测试了参与者人口统计和基线临床特征的站点间差异。回归检查了认知变化（MCCB）和功能能力（UPSA）的预测因子，这可以解释治疗效果的部位差异。 MCCB 和 UPSA 的中到大治疗效果差异有利于纽约地点而不是洛杉矶。当将这些研究合并时，地点对两种结果的影响都很显着，且影响大小差异中等。在控制背景特征后，地点对这两种结果的影响都降低了，但对认知仍然很重要。 UPSA 的改善与较好的基线 MCCB (p<0.001)、较低的基线 UPSA (p<0.001) 和较年轻的年龄 (p=0.019) 相关。包含地点、基线分数和参与者背景特征的整体模型解释了大约 30% 到 40% 的结果差异。参与者和治疗特征均可预测结果，但治疗特征可能对认知增益更重要，而参与者特征可能对功能能力的变化更重要。
Collaborative data sharing between research groups provides an opportunity to explore the basis for the heterogeneity in cognitive training outcomes reported in the schizophrenia literature. The current analyses focused on the contribution of site and participant characteristics to these heterogeneous outcomes. Data from two independent studies, from New York (NY) and Los Angeles (LA), were combined to yield a sample of 132 outpatient adults with schizophrenia/schizoaffective disorder. While similar treatment doses, cognitive exercises and outcome measures were used, sites differed in use of coaching, group discussion and compensation. Between-site differences in participant demographic and baseline clinical characteristics were tested. Regression examined predictors of change in cognition (MCCB) and functional capacity (UPSA) which could explain site differences in treatment effects. Medium to large treatment effect size differences in MCCB and UPSA favored the NY site over LA. When the studies were combined, the effect of site was significant for both outcomes with a medium effect size difference. After controlling for background characteristics, the effect of site was reduced for both outcomes, but remained significant for cognition. Improvement in UPSA was associated with better baseline MCCB (p<0.001), lower baseline UPSA (p<0.001) and younger age (p=0.019). The overall model with site, baseline scores, and participant background characteristics explained about 30% to 40% of the variance in outcomes. Participant and treatment characteristics are both predictive of outcomes, but treatment characteristics may be more consequential to cognitive gain, while participant characteristics may be more consequential to change in functional capacity.
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