精神分裂症新试验的证据与现有证据在哪里相符:皇帝新衣的案例?

IF 3.6 Q1 PSYCHIATRY Schizophrenia Research and Treatment Pub Date : 2012-01-01 Epub Date: 2012-04-08 DOI:10.1155/2012/625738
Mahesh Jayaram, Ranganath D Rattehalli, Clive E Adams
{"title":"精神分裂症新试验的证据与现有证据在哪里相符:皇帝新衣的案例?","authors":"Mahesh Jayaram,&nbsp;Ranganath D Rattehalli,&nbsp;Clive E Adams","doi":"10.1155/2012/625738","DOIUrl":null,"url":null,"abstract":"<p><p>Advent of \"atypical\" antipsychotics has spawned new trials in the recent years and the number of such trial reports has been increasing exponentially. As clinicians we have been led to believe that \"atypicals\" are better than \"typicals\" despite the odd dissenting voice in academic and clinical circles. This has been largely ignored until the publication of two landmark, independent, pragmatic trials, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS), which proved that thoughtfully chosen \"typical\" antipsychotics were as good as the newer \"atypicals.\" We pooled \"leaving the study early data\" from Cochrane Reviews that existed before CATIE and CUtLASS and added data from CATIE and CUtLASS to the pool for a \"before and after\" comparison. Addition of CATIE and CUtLASS data only led to narrowing of the already existing confidence intervals, merely increasing precision, and decreasing the risk of Type II error. Perhaps surprisingly, CATIE and CUtLASS when pooled with the already existing data showed us that we had chosen to turn a blind eye to findings that already existed. This leads clinicians to question as to whether, in future, we need to feel less guilty about crying out early on that the emperor has no clothes on.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/625738","citationCount":"2","resultStr":"{\"title\":\"Where Does Evidence from New Trials for Schizophrenia Fit with the Existing Evidence: A Case of the Emperor's New Clothes?\",\"authors\":\"Mahesh Jayaram,&nbsp;Ranganath D Rattehalli,&nbsp;Clive E Adams\",\"doi\":\"10.1155/2012/625738\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Advent of \\\"atypical\\\" antipsychotics has spawned new trials in the recent years and the number of such trial reports has been increasing exponentially. As clinicians we have been led to believe that \\\"atypicals\\\" are better than \\\"typicals\\\" despite the odd dissenting voice in academic and clinical circles. This has been largely ignored until the publication of two landmark, independent, pragmatic trials, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS), which proved that thoughtfully chosen \\\"typical\\\" antipsychotics were as good as the newer \\\"atypicals.\\\" We pooled \\\"leaving the study early data\\\" from Cochrane Reviews that existed before CATIE and CUtLASS and added data from CATIE and CUtLASS to the pool for a \\\"before and after\\\" comparison. Addition of CATIE and CUtLASS data only led to narrowing of the already existing confidence intervals, merely increasing precision, and decreasing the risk of Type II error. Perhaps surprisingly, CATIE and CUtLASS when pooled with the already existing data showed us that we had chosen to turn a blind eye to findings that already existed. This leads clinicians to question as to whether, in future, we need to feel less guilty about crying out early on that the emperor has no clothes on.</p>\",\"PeriodicalId\":45388,\"journal\":{\"name\":\"Schizophrenia Research and Treatment\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2012-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2012/625738\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Schizophrenia Research and Treatment\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2012/625738\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2012/4/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Schizophrenia Research and Treatment","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2012/625738","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2012/4/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 2

摘要

近年来,“非典型”抗精神病药物的出现催生了新的试验,此类试验报告的数量呈指数级增长。作为临床医生,我们一直被引导相信“非典型”比“典型”好,尽管在学术和临床圈子里有奇怪的反对声音。这在很大程度上被忽视了,直到两项具有里程碑意义的、独立的、实用的试验——精神分裂症研究中最新抗精神病药物的干预有效性临床抗精神病药物试验(CATIE)和成本效用(CUtLASS)的发表,证明了精心选择的“典型”抗精神病药物与较新的“非典型”抗精神病药物一样好。我们汇集了在CATIE和CUtLASS之前存在的Cochrane综述中的“早期离开研究数据”,并将CATIE和CUtLASS的数据加入到“前后”比较池中。CATIE和CUtLASS数据的增加只导致已经存在的置信区间的缩小,仅仅增加了精度,并降低了II型错误的风险。也许令人惊讶的是,当CATIE和CUtLASS与已经存在的数据结合在一起时,我们发现我们选择了对已经存在的发现视而不见。这让临床医生提出了一个问题:在未来,我们是否需要对过早地大喊“皇帝没穿衣服”感到不那么内疚?
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Where Does Evidence from New Trials for Schizophrenia Fit with the Existing Evidence: A Case of the Emperor's New Clothes?

Advent of "atypical" antipsychotics has spawned new trials in the recent years and the number of such trial reports has been increasing exponentially. As clinicians we have been led to believe that "atypicals" are better than "typicals" despite the odd dissenting voice in academic and clinical circles. This has been largely ignored until the publication of two landmark, independent, pragmatic trials, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS), which proved that thoughtfully chosen "typical" antipsychotics were as good as the newer "atypicals." We pooled "leaving the study early data" from Cochrane Reviews that existed before CATIE and CUtLASS and added data from CATIE and CUtLASS to the pool for a "before and after" comparison. Addition of CATIE and CUtLASS data only led to narrowing of the already existing confidence intervals, merely increasing precision, and decreasing the risk of Type II error. Perhaps surprisingly, CATIE and CUtLASS when pooled with the already existing data showed us that we had chosen to turn a blind eye to findings that already existed. This leads clinicians to question as to whether, in future, we need to feel less guilty about crying out early on that the emperor has no clothes on.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.60
自引率
0.00%
发文量
2
审稿时长
14 weeks
期刊介绍: Schizophrenia Research and Treatment is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to all aspects of schizophrenia.
期刊最新文献
Adherence to Typical Antipsychotics among Patients with Schizophrenia in Uganda: A Cross-Sectional Study. Investigating Body Mass Index and Body Composition in Patients with Schizophrenia: A Case-Control Study Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications. Comparison of Efficacy and Safety between Long-Acting Injectable Antipsychotic Monotherapy and Combination of Long-Acting Injectable and Oral Antipsychotics in Patients with Schizophrenia. Homocysteine in Schizophrenia: Independent Pathogenetic Factor with Prooxidant Activity or Integral Marker of Other Biochemical Disturbances?
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1