What works for Whom in Pediatric OCD

什么对儿童强迫症患者有效

基本信息

批准号：
10665713
负责人：
DAVID Heaton BARKER
金额：
$ 34.69万
依托单位：
EMMA PENDLETON BRADLEY HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-15 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10665713
关键词：
Address Age Apple Behavior Therapy Caregivers Characteristics Child Childhood Clinical Clinical Data Clinical Trials Cognitive Cognitive Therapy Data Development Dose Education Emotional Evaluation Evidence based intervention Family Family psychotherapy Foundations Head Hospitals Individual Infrastructure International Intervention Leadership Length Measures Meta-Analysis Methods Modality Modification National Institute of Mental Health Obsessive-Compulsive Disorder Outcome Participant Patient advocacy Patient-Focused Outcomes Patients Population Prevention Principal Investigator Process Recording of previous events Relaxation Research Sample Size Sampling Schedule Severities Severity of illness Statistical Models Subgroup Symptoms Target Populations Testing Time Transportation Treatment Effectiveness Treatment Efficacy Variant Work analytical tool burden of illness comorbidity comparative effectiveness compare effectiveness comparison intervention data archive ethnic minority population improved insight member outpatient programs patient subsets programs racial minority population randomized trial reduce symptoms response social therapy outcome treatment comparison treatment response usability

项目摘要

Project Summary/Abstract Improving patient outcomes will be enhanced by understanding “what works, for whom?” enabling better matching of patients to available treatments. Despite a wealth of research seeking to optimize CBT outcomes for pediatric obsessive-compulsive disorder (OCD), we have limited understanding about how to match patients with the appropriate treatment package. Past research has identified patient characteristics that may influence treatment response, including age, symptom severity, comorbidities, and previous treatment history. Unfortunately, findings have been inconsistent due to limited sample size, a focus on one modifier at a time, and difficulty integrating results across trials with different sample characteristics. Between-trial differences in sample characteristics severely limit conventional meta-analytic tools, greatly complicating cross-trial comparisons of treatment efficacy. This project will use individual-participant-data from 27 trials and data from two clinical populations and utilize recent advancements in transportability methods facilitates understanding “what works, for whom?” Transportability methods include causal analytic approaches to extend inferences from trial samples to target populations when there are marked differences in the distribution of sample characteristics between trials and the target population. Robust statistical models are used to address between-trial differences in covariates, enabling the transportation of causal estimates from trial samples to target populations. Under explicit causal and statistical assumptions, the transported analyses provide unbiased estimates of how interventions will fair in the target population(s), enabling apples-to-apples comparisons of interventions even when two interventions have not been compared in a head-to-head trial. In addition, the target population can be defined as sub-populations (e.g., younger children with high illness severity, comorbidities), enabling evaluation of relevant interventions for that sub-population, effectively providing insight into the question of “what works for whom?”

项目摘要/摘要通过了解“什么有效，为谁？”来改善患者的结果将得到增强。使得更好将患者与可用治疗相匹配。尽管大量的研究试图优化CBT结果对于小儿强迫症（OCD），我们对如何匹配的了解有限具有适当治疗方案的患者。过去的研究已经确定了可能影响治疗反应，包括年龄，症状严重程度，合并症和以前的治疗史。不幸的是，由于样本量有限，发现结果不一致，重点是一个修饰符时间，以及在具有不同样本特征的试验中的困难整合结果。试验间样本特征的差异严重限制了常规的荟萃分析工具，极大地复杂化治疗效率的跨试验比较。该项目将使用27次试验中的个人参与者数据，并且来自两个临床人群的数据，并利用可运输方法的最新进展有助于理解“什么有效，为谁？”可运输方法包括因果分析方法当分布有明显差异时，将推论从试验样本扩展到目标人群试验和目标人群之间的样本特征。使用强大的统计模型为了解决协变量的试验间差异，使试验的因果估计值能够运输样本以目标人群。在明确的因果和统计假设下，运输的分析提供无偏见的估计值，即在目标人群中如何进行干预措施，从而实现苹果到苹果即使在头对头试验中没有比较两种干预措施，干预措施的比较。在此外，目标人群可以定义为子人群（例如，患有高病的年幼儿童严重性，合并症），有效地评估该子人群的相关干预措施提供有关“为谁有效的问题？”的洞察力。