1. Prognostic Risk Factors in Randomized Clinical Trials of Face-to-Face and Internet-Based Psychotherapy for Depression
- Author
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Merzhvynska, Mariia; https://orcid.org/0000-0002-8871-2875, Wolf, Markus; https://orcid.org/0000-0002-5660-6824, Krieger, Tobias, Berger, Thomas; https://orcid.org/0000-0002-2432-7791, Munder, Thomas; https://orcid.org/0000-0002-0996-512X, Watzke, Birgit; https://orcid.org/0000-0002-6662-5818, Merzhvynska, Mariia; https://orcid.org/0000-0002-8871-2875, Wolf, Markus; https://orcid.org/0000-0002-5660-6824, Krieger, Tobias, Berger, Thomas; https://orcid.org/0000-0002-2432-7791, Munder, Thomas; https://orcid.org/0000-0002-0996-512X, and Watzke, Birgit; https://orcid.org/0000-0002-6662-5818
- Abstract
Importance Variables such as severe symptoms, comorbidity, and sociodemographic characteristics (eg, low educational attainment or unemployment) are associated with a poorer prognosis in adults treated for depressive symptoms. The exclusion of patients with a poor prognosis from RCTs is negatively associated with the generalizability of research findings. Objective To compare the prognostic risk factors (PRFs) in patient samples of RCTs of face-to-face therapy (FTF) and internet-based therapy (IBT) for depression. Data Sources PsycINFO, Cochrane CENTRAL, and reference lists of published meta-analyses were searched from January 1, 2000, to December 31, 2021.Study SelectionRCTs that compared FTF (individual or group therapy) and IBT (guided or self-guided interventions) against a control (waitlist or treatment as usual) in adults with symptoms of depression were included. Data Extraction and Synthesis Data were extracted by 2 independent observers. The Cochrane revised risk-of-bias tool was used to assess the risk of bias. The study was preregistered with OSF Registries and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures The primary outcome was the standardized mean difference (Hedges g effect size) in depressive symptoms at treatment termination (assessed with standard patient self-report questionnaires), with a positive standardized mean difference indicating larger improvements in the intervention compared with those in the control group. Meta-regression analyses were adjusted for the type of control group. Three preregistered and 2 exploratory sensitivity analyses were conducted. A prognostic risk index (PROG) was created that calculated the sum of 12 predefined individual indicators, with scores ranging from 0 to 12 and higher scores indicating that a sample comprised patients with poorer prognoses. Results This systematic review and meta-regression analysis identified 105 el
- Published
- 2023