A Cohort Study of Summary Reports of Controlled Trials

Chalmers, Iain; Adams, Miriam E.; Dickersin, Kay; Hetherington, Jini; Tarnow‐Mordi, William; Meinert, Curtis L.; Tonascia, Susan; Chalmers, Thomas C.

doi:10.1001/jama.1990.03440100117017

Cited by 186 publications

(74 citation statements)

References 16 publications

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“…Table 2 presents the moderator variables that were hypothesised to explain variance in attendance outcomes: (a) type of attendance (TR or PT), (b) attendance intervention strategy, (c) the sample diagnosis, (d) measurement of attendance, (e) whether the attendance intervention was carried out in a group or with individuals, (f) whether studies involved an active or passive control group, (g) the country of origin for the study (to examine healthcare context effects), and (h) study quality. Study quality was (assessed via the three rating scales developed by Chalmers et al, (1990)., which assess (a) method of treatment assignment (lowest score given to studies where randomization was not mentioned, highest score given to studies where the treatment assignment process was truly randomized), (b) control of selection bias after treatment assignment (lowest score given to studies where results were analyzed only by treatment received, highest score given to studies where results were analyzed by original treatment assignment), and (c) blinding of participants and investigators (lowest score given to studies where double-blinding was possible but was not usedgiven to studies which reported using double-blinding, highest score given to studies which reported using double-blinding given to studies where double-blinding was possible but was not used).…”

Section: Meta-analysis Strategymentioning

confidence: 99%

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Oldham¹,

Kellett²,

Miles³

et al. 2012

Journal of Consulting and Clinical Psychology

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Objective: Rates of non-attendance for psychotherapy hinder the effective delivery of evidencebased treatments. Although many strategies have been developed to increase attendance, the effectiveness of these strategies has not been quantified. The aim of the present study was to undertake a meta-analysis of rigorously controlled studies to quantify the effects of interventions to promote psychotherapy attendance.Method: The inclusion criteria were that studies (1) concerned attendance at individual or group psychotherapy by adults, (2) used a randomised controlled trial design to test an attendance strategy, and (3) used an objective measure of attendance. Computerised literature searches and hand searching resulted in a total of 31 RCTs that involved 33 independent tests of strategies for reducing treatment refusal and premature termination (N = 4,422). Effect sizes from individual studies were meta-analysed and moderator analyses were conducted.Results: Interventions had a small-to-medium effect on attendance across studies (d + = .38).Interventions to reduce treatment refusal and premature termination were similarly effective (d + = .37 and .39, respectively). Choice of appointment time or therapist, motivational interventions, preparation for psychotherapy, informational interventions, attendance reminders, and case management were the most effective strategies. Diagnosis also moderated effect sizes; samples with a single diagnosis benefited more from attendance interventions than samples that had a variety of diagnoses.Conclusions: Interventions to increase attendance at adult psychotherapy are moderately effective.However, relatively few studies met the strict study inclusion criteria. Further methodologically sound and theoretically informed interventions geared at increasing attendance are required. META-ANALYSIS OF PSYCHOTHERAPY ATTENDANCE 3Interventions to Increase Attendance at Psychotherapy:A Meta-Analysis of Randomised Controlled Trials A substantial proportion of clinical time is wasted because of patient non-attendance at scheduled adult psychotherapy appointments (Pekarik, 1985). The financial costs of nonattendance are marked (Hicks & Hickman, 1995; Kleine, Stone, Hicks & Pritchard, 2003), with patients not receiving help (Joshi, Maisami & Coyle, 1986) and therapists losing confidence as a result (Sledge, Moras, Hartley & Levine, 1990). Service efficiency is impaired when nonattendance rates are high (Rusius, 1995). Garfield (1994) noted that some patients fail to attend at assessment and essentially reject treatment. Hampton-Robb, Qualls, and Compton (2003) estimated that such treatment refusal (TR) occurs for 40% of referrals, on average. Premature termination (PT) occurs when patients fail to complete agreed treatment contracts (i.e., they 'drop-out' of therapy). A meta-analysis of 123 studies reported a PT rate of 46.8% (Wierzbicki & Pekarik, 1993) across treatment modalities. High PT rates are troubling in light of evidence that PT is associated with poor clinical outcome (Barret...

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Section: Meta-analysis Strategymentioning

confidence: 99%

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Oldham¹,

Kellett²,

Miles³

et al. 2012

Journal of Consulting and Clinical Psychology

View full text Add to dashboard Cite

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“…What are the barriers preventing researchers conducting double-blind trials? It would be interesting to assess other aspects of design, such as intention-to-treat analysis, generation of randomisation, concealment of treatment and allocation sequence [6,8,13], to see if they are also inadequately conducted.…”

Section: Discussionmentioning

confidence: 99%

“…Initiatives were taken to improve research design and reporting of clinical trials. Recommendations were made to improve the internal validity of trials, promoting design features such as randomisation, double-blinding and large sample sizes [6,8]. The CONSORT guidelines [7], which made recommendations about the reporting of clinical trials, were formulated and have since been updated [9].…”

Section: Introductionmentioning

confidence: 99%

Controlled clinical trials in cystic fibrosis — are we doing better?

Briggs

Bryant

Smyth

2006

Journal of Cystic Fibrosis

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We have previously reported the time trends, design and interventions in randomised controlled trials (RCTs) in cystic fibrosis (CF) from 1961 through 1997 [Cheng K, Smyth RL, Motley J, O'Hea U, Ashby D, Randomised controlled trials in cystic fibrosis (1966-1997) categorized by time, design, and intervention. Pediatr Pulmonol 2000, 29:1-7.]. We maintain an ongoing register of all RCTs and controlled clinical trials (CCTs) in CF and have noted that in the five years since 1997 there has been a 48% increase in published trials. We aimed to assess whether this increase has been associated with an improvement in design quality. All RCTs and CCTs from 1961-2002 were assessed. Two epochs were then compared, 1961-1997 and 1998-2002. For each trial we recorded the design, participant numbers and the intervention studied. 261 trials in 1998-2002 were compared with 544 trials in 1961-1997. Comparing the two epochs a similar proportion of trials were parallel, double-blind and placebo controlled; also the median number of participants was similar. In the later epoch 25% of trials were multicentre, compared with 11% previously. Whilst this recent increase in clinical trials in CF is welcome, this has not been associated with improvements in quality. The trend for an increasing proportion of trials to be multicentre is encouraging. There are however, still deficiencies in the design of clinical trials in CF.

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“…Table 2 illustrates this by describing the first 5 quality scales described by Jü ni et al, 4 listed alphabetically by the first author of the article introducing the scale. Included are the 2 influential quality scales of T Chalmers et al, 9 discussed above, and I Chalmers et al 10 In fairness, different groups had different goals in defining their quality scales. For example, I Chalmers et al were only concerned with internal validity, 10 whereas T Chalmers et al were concerned with a broader notion of study quality.…”

Section: Quality Scalesmentioning

confidence: 99%

“…Included are the 2 influential quality scales of T Chalmers et al, 9 discussed above, and I Chalmers et al 10 In fairness, different groups had different goals in defining their quality scales. For example, I Chalmers et al were only concerned with internal validity, 10 whereas T Chalmers et al were concerned with a broader notion of study quality. 9 Nonetheless, as of the early 1990s, T Chalmers et al's quality scale was sometimes treated as an all-purpose ''gold standard'', though not in T Chalmers's articles.…”

Section: Quality Scalesmentioning

confidence: 99%

Are Quality Assessment Methods Any Good?

Hodges

2004

Journal of Evidence Based Dental Practice

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A Cohort Study of Summary Reports of Controlled Trials

Cited by 186 publications

References 16 publications

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Controlled clinical trials in cystic fibrosis — are we doing better?

Are Quality Assessment Methods Any Good?

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