Treatment Effectiveness Score as an Outcome Measure in Clinical Trials

Ling, Walter; Shoptaw, Steven; Wesson, Donald R.; Rawson, Richard A.; Compton, Margaret; Klett, C. James

doi:10.1037/e495552006-011

Cited by 42 publications

(43 citation statements)

References 5 publications

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“…The primary study outcome was MA use as assessed via urine drug screens and secondary outcomes were treatment retention, depressive symptoms, MA cravings, and adverse events. The following aggregate measures of urine drug screen results were calculated: the Joint Probability Index at six and twelve weeks of treatment (the number of MA-metabolite free urine specimens submitted by participants in each treatment group at that time divided by the number of participants randomized to the treatment group) and the Treatment Effectiveness Score (the sum of the number of MA-free urine samples submitted per participant (Ling et al, 1997), the percentage of samples negative for MA overall, the longest consecutive period of MA abstinence, and the percentage of participants with at least 2 and at least 3 consecutive weeks of MA abstinence. Univariate comparisons of baseline demographic, drug use, and psychiatric characteristics of participants as well as comparisons of missing data rates, aggregate measures of urine drug screen results, medication adherence, and MA craving by treatment group assignment were performed using analysis of variance (ANOVA) for continuous variables and chi square for categorical variables (Tabachnick and Fidell, 2000).…”

Section: Discussionmentioning

confidence: 99%

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Shoptaw

Heinzerling

Rotheram-Fuller

et al. 2008

Drug and Alcohol Dependence

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138

129

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Objective-To compare bupropion to placebo for reducing methamphetamine (MA) use, increasing retention, and reducing the severity of depressive symptoms and MA cravings. A secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants.Methods-Following a 2-week, non-medication baseline screening period, 73 treatment-seeking MA dependent participants were randomly assigned to bupropion sustained release (150 mg twice daily; N=36) or placebo (twice daily; N=37) for 12-weeks under double blind conditions. Participants attended clinic thrice weekly to provide urine samples analyzed for MA-metabolite, to complete research measures and assessments, and to receive contingency management and weekly cognitive behavioral therapy sessions.Results-There were no statistically significant effects for bupropion relative to placebo on MA use verified by urine drug screens, for reducing the severity of depressive symptoms or MA cravings, or on study retention. In a post hoc analysis, there was a statistically significant effect of bupropion treatment on MA use among participants with lighter (0-2 MA-positive urines), but not heavier (3-6 MA-positive urines) MA use during baseline (OR=2.81, 95% CI=1.61-4.93, p<0.001 for MA-free week with bupropion among light users). Bupropion treatment was also associated with significantly reduced cigarette smoking, by almost 5 cigarettes per day (p=0.0002).Conclusion-Bupropion was no more effective than placebo in reducing MA use in planned analyses, though bupropion did reduce cigarette smoking. Post hoc findings of an effect for bupropion among baseline light, but not heavy, MA users suggests further evaluation of bupropion for light MA users is warranted.

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Section: Discussionmentioning

confidence: 99%

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Shoptaw

Heinzerling

Rotheram-Fuller

et al. 2008

Drug and Alcohol Dependence

Self Cite

138

129

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“…This study is the first to show an association between brain activation during drug cue exposure and vulnerability to both treatment dropout and relapse to cocaine use as assessed by the TES (Ling et al, 1997). Those CD patients with worse outcomes (eg relapsers with early dropout, more cocaine use, lower TES) had greater activation of sensory, Cocaine use (#days/mo) 20 (9) 21 (9) Cocaine use (#yrs) 4.7 (5) 7.9 (5) Alcohol (#days/mo) b 7 (7) 15 (9) Alcohol (#yrs) c 20 (6) 23 (4) Tobacco (pks/day) 0.6 (0.5) 0.8 (0.8)…”

Section: Discussionmentioning

confidence: 99%

“…The subjects' fMRI responses were correlated with the TES and then used to compare nonrelapsers to relapsers (Ling et al, 1997). The TES score is the total number of cocaine-free urines provided by a subject during the outpatient portion of the study and ranged from 0 to 30, the best outcome.…”

Section: Functional Mri and Statistical Analysesmentioning

confidence: 99%

“…In the current pilot study, we examined the potential of brain activity changes in response to cocaine cues to predict relapse to cocaine use as assessed using the Treatment Effectiveness Score (TES) (Ling et al, 1997). The TES is the sum of all cocaine-free urines during the treatment trial, and we correlated the TES with regions of brain activation on fMRI during cocaine cue exposure.…”

Section: Introductionmentioning

confidence: 99%

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Cue-Induced Brain Activity Changes and Relapse in Cocaine-Dependent Patients

Kosten

Scanley

Tucker

et al. 2005

Neuropsychopharmacol

286

231

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This study used functional magnetic resonance imaging (fMRI) to examine the association between brain activation during exposure to cocaine-related cues and relapse to drug use in cocaine-dependent (CD) patients. We imaged 17 CD subjects during a 2-week in-patient stay. The subjects then entered a 10-week outpatient placebo-controlled, double-blind randomized clinical trial where urine toxicologies were assessed three times weekly to calculate the treatment effectiveness score (TES). Worse TES correlated with BOLD activation in the left precentral, superior temporal, and posterior cingulate cortices (PCC), and right middle temporal and lingual cortices (R40.65; Po0.005). The left PCC activation also distinguished eight nonrelapsers (TES above mean and completed treatment) from nine relapsers. Cocaine-free urines were significantly greater in the nonrelapsers (92%) than in the relapsers (66%), who also remained in treatment for an average of only 3.2 weeks. Self-reports of craving during fMRI did not differ between nonrelapsers and relapsers and did not correlate with TES. Relapse to cocaine abuse was associated with increased activation in the sensory association cortex, the motor cortex, and PCC while viewing images of cocaine-related cues. These results suggest that relapse to cocaine abuse is associated with increased brain activation to cocaine cues in sensory, motor, and cognitive-emotional processing areas. This physiological activation was a better predictor of relapse than subjective reports of craving, and may be a useful target for treatment development.

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“…More recent trials have attempted to deal with this problem using the Treatment Effectiveness Score (TES) as proposed by Ling and colleagues. 165 According to the TES, each patient is given a score from 0 to 100% calculated as number of negative (or positive) urine samples divided by the total number of possible urine samples that could have been taken. Missing urine samples (whether from patients retained in treatment or not retained in treatment) are assumed to be positive.…”

Section: Assessment Of Opioid Usementioning

confidence: 99%

Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation

Connock¹,

Juarez-Garcia²,

Jowett³

et al. 2007

Health Technol Assess

437

360

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Treatment Effectiveness Score as an Outcome Measure in Clinical Trials

Cited by 42 publications

References 5 publications

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Cue-Induced Brain Activity Changes and Relapse in Cocaine-Dependent Patients

Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation

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