Advancing Transdisciplinary Translation for Prevention of High-Risk Behaviors: Introduction to the Special Issue

Fishbein, Diana H.; Ridenour, Ty

doi:10.1007/s11121-013-0394-6

Cited by 18 publications

(14 citation statements)

References 25 publications

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“…Specifically demonstrated was that USEM and MMTA coupled with subject-as-own-control designs and time series data provide powerful techniques for testing intervention mechanisms. Being able to employ combinations of features from ICTs and RCTs is especially valuable in light of emerging emphases by research funders to understand mechanisms of treatment and prevention, precision medicine, and value-based healthcare (Fishbein et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

“…RCTs rarely present data to understand heterogeneity in treatment responses. As a result, person-centered, value-based medicine, and medical home model movements have risen in healthcare and psychological treatment in attempt to enhance RCTs by obtaining treatment-related evidence specifically for clinical decision-making (Fishbein et al, 2013 ; Fisher, 2008 ; Guyatt et al, 2000 ; Hunter & Goodie, 2010 ; Rosenthal, 2008 ; Roth & Fonagy, 2006 ; Tarter et al, 2013), joining long-standing champions of ICTs (e.g., Ferron, et al, 2009 ; Kazdin, 2011 ; Kratochwill et al, 2010 ; Ottenbacher, 1986 ; Shadish, 2014 ) in recognizing the limits of RCTs for informing clinical decisions.…”

Section: Traditional Rct Approach To Inform Clinical Decisionsmentioning

confidence: 99%

“…In certain ways, this is unfortunate for clinicians because treatment requires (a) decision-making about how to best treat an individual using the available interventions while taking into account individual differences in response to interventions (whereas RCT evidence is largely limited to population-or large subpopulation-aggregate estimates of efficacy and effectiveness); (b) short-and long-term monitoring of individuals (e.g., to confirm that a treatment is having the desired impact or to change treatment strategy); and (c) techniques, tools, and combinations thereof which are specialized to remedy an illness according to the needs of each individual client/patient. This need for evidence-based clinical decision-making and the limits of dichotomizing RCT vs ICT has led to (a) repeated calls to understand which treatments work for whom and under what conditions (Fishbein & Ridenour, 2013 ; Guyatt et al, 2000 ; Roth & Fonagy, 2006 ); (b) evolving medical home models (Fisher, 2008 ; Hunter & Goodie, 2010 ; Rosenthal, 2008 ; Tarter, Horner, Ridenour, & Bogen, 2013 ); and (c) movements to promote personalized and value-based medicine. To illustrate, the Patient-Centered Outcomes Research Institute was founded in 2010 because “traditional medical research, for all of the remarkable advances in care it produces, hasn’t been able to answer many of the questions that patients and their clinicians face daily…” (PCORI, 2014 ).…”

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confidence: 99%

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The clinical trials mosaic: Toward a range of clinical trials designs to optimize evidence-based treatment

Ridenour

Chen

Liu

et al. 2017

JPOR

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Objective: Dichotomizing clinical trials designs into nomothetic (e.g., randomized clinical trials or RCTs) versus idiographic (e.g., N-of-1 or case studies) precludes use of an array of hybrid designs and potential research questions between these extremes. This paper describes unique clinical evidence that can be garnered using idiographic clinical trials (ICTs) to complement RCT data. Proposed and illustrated herein is that innovative combinations of design features from RCTs and ICTs could provide clinicians with far more comprehensive information for testing treatments, conducting pragmatic trials, and making evidence-based clinical decisions. Method: Mixed model trajectory analysis and unified structural equations modeling were coupled with multiple baseline designs in (a) a true N-of-1 pilot study to improve severe autism-related communication deficits and (b) a small sample preliminary study of two complimentary interventions to relieve wheelchair discomfort. Results: Evidence supported certain mechanisms of treatment outcomes and ruled out others. Effect sizes included mean phase differences (i.e., effectiveness), trajectory slopes, and differences in path coefficients between study phases. Conclusions: ICTs can be analyzed with equivalent rigor as, and generate effect sizes comparable to, RCTs for the purpose of developing hybrid designs to augment RCTs for pilot testing innovative treatment, efficacy research on rare diseases or other small populations, quantifying within-person processes, and conducting clinical trials in many situations when RCTs are not feasible.

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Section: Discussionmentioning

confidence: 99%

Section: Traditional Rct Approach To Inform Clinical Decisionsmentioning

confidence: 99%

mentioning

confidence: 99%

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The clinical trials mosaic: Toward a range of clinical trials designs to optimize evidence-based treatment

Ridenour

Chen

Liu

et al. 2017

JPOR

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“…Unfortunately, programs of this ilk are often costly to deliver, participation and completion rates are generally poor, and modest effect sizes have been reported on key outcomes with considerable variability in individual response [8]. To address these limitations, some prevention scientists have called for Bpersonalized^ap-proaches [9][10][11][12][13]. Personalized health care (i.e., personalized medicine, precision medicine) uses an individual's unique characteristics (genetic profiles, biomarkers, environmental exposures) to make decisions regarding the best intervention strategy for an individual [14].…”

Section: Discussionmentioning

confidence: 99%

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

Thibodeau

August

Cicchetti

et al. 2015

Behav. Med. Pract. Policy Res.

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Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes. One compelling body of literature on person × environment interactions is that of environmental sensitivity theories, including differential susceptibility theory and vantage sensitivity. Recent experimental evidence has demonstrated that environmental sensitivity (ES) factors moderate substance abuse outcomes. We propose that ES factors may augment current personalization strategies such as matching based on risk factors/severity of problem behaviors (risk severity (RS)). Specifically, individuals most sensitive to environmental influence may be those most responsive to intervention in general and thus need only a brief-type or lower-intensity program to show gains, while those least sensitive may require more comprehensive or intensive programming for optimal responsiveness. We provide an example from ongoing research to illustrate how ES factors can be incorporated into prevention trials aimed at high-risk adolescents. Keywords Substance use, Prevention, Environmental sensitivity, R i s k s e v e r i t y, D i ff e r e n t i a l s u s c e p t i b i l i t y, PersonalizationAlcohol and other drug use among adolescents is a serious public health concern in the USA. For example, by late adolescence, over 78 % of teens will have experimented with alcohol, over 47 % will be engaged in regular drinking habits, and over 14 % will have met criteria for lifetime abuse [1]. Despite herculean efforts over the previous five decades to stem the rising tide of substance use, treatment approaches (largely based on behavioral parent training and cognitive behavioral therapy principles) have been modest at best; there is considerable variability in outcomes, and no one model works similarly for all youth [2]. Even among those who experience initial success following treatment, relapse rates are high [3].

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“…As a result, catecholamine oversecretion can cause significant perioperative morbidity and mortality. Early publications reported surgical mortality rates of 30–45%; however, with current medical management and new surgical techniques, the surgical mortality rate has been significantly improved to 0–2.9% [10] , [11] . Therefore, it is recommended that all patients receive appropriate preoperative medical management to block the effects of circulating catecholamines [12] , [13] .…”

Section: Discussionmentioning

confidence: 99%

Craniotomy for cerebellar hemangioblastoma excision in a patient with von Hippel–Lindau disease complicated by uncontrolled hypertension due to pheochromocytoma

Mizobuchi

Kageji

Yamaguchi

et al. 2015

International Journal of Surgery Case Reports

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HighlightsThis report describes a patient with VHL syndrome and uncontrolled hypertension due to pheochromocytoma who developed obstructive hydrocephalus and underwent craniotomy for the excision of a cerebellar hemangioblastoma combined with a laparoscopic adrenalectomy.A rare case of cerebellar hemangioblastoma excision in a patient with von Hippel–Lindau disease complicated by uncontrolled hypertension due to pheochromocytoma.There is hardly any literature on emergency craniotomy in a patient with von Hippel–Lindau disease.There are no clear treatment guidelines for the emergency excision of cerebellar hemangioblastomas in patients with intracranial hypertension complicated by abnormal hypertension due to pheochromocytoma whose blood pressure is not sufficiently controlled before surgery.

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Advancing Transdisciplinary Translation for Prevention of High-Risk Behaviors: Introduction to the Special Issue

Cited by 18 publications

References 25 publications

The clinical trials mosaic: Toward a range of clinical trials designs to optimize evidence-based treatment

The clinical trials mosaic: Toward a range of clinical trials designs to optimize evidence-based treatment

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

Craniotomy for cerebellar hemangioblastoma excision in a patient with von Hippel–Lindau disease complicated by uncontrolled hypertension due to pheochromocytoma

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