Antidepressant prescriptions have not fully reflected evolving evidence from cumulative network meta-analyses and guideline recommendations
نویسندگان
چکیده
ObjectivesThis study compares three major elements of evidence-based medicine (EBM) practices, namely evidence synthesis, clinical practice guidelines (CPGs), and real-world prescriptions in the United States, regarding antidepressant treatments depression over past 3 decades.Study Design SettingWe conducted network meta-analyses (NMAs) antidepressants every 5 years up to 2016 based on a comprehensive data set double-blind randomized controlled trials. We identified CPGs extracted their recommendations. surveyed States at 5-year intervals 2015.ResultsMost drugs recommended by presented favorable performance efficacy acceptability NMAs. However, CPG recommendations were often terms drug classes rather than individual drugs, whereas NMAs suggested distinctive difference between within same class. The update all longer years. All prescribed frequently CPGs. changes did not correspond alterations or apparent effects indicated Many factors including marketing efforts, regulations, patient values may have played role.ConclusionEnhancements accelerating updates monitoring impact should be considered future EBM implementation.
منابع مشابه
Evaluating heterogeneity in cumulative meta-analyses
BACKGROUND Recently developed measures such as I2 and H allow the evaluation of the impact of heterogeneity in conventional meta-analyses. There has been no examination of the development of heterogeneity in the context of a cumulative meta-analysis. METHODS Cumulative meta-analyses of five smoking cessation interventions (clonidine, nicotine replacement therapy using gum and patch, physician...
متن کاملWORKSHEET for PROPOSED Evidence-Based GUIDELINE RECOMMENDATIONS
STEP 1: STATE THE PROPOSAL. Revision to current statement. Existing guideline, practice or training activity, or new guideline: Revision to current guideline Check the blood glucose level during stabilization after resuscitation Step 1A: Refine the question; state the question as a positive (or negative) hypothesis. State proposed guideline recommendation as a specific, positive hypothesis. Use...
متن کاملCommunity-Augmented Meta-Analyses: Toward Cumulative Data Assessment.
We present the concept of a community-augmented meta-analysis (CAMA), a simple yet novel tool that significantly facilitates the accumulation and evaluation of previous studies within a specific scientific field. A CAMA is a combination of a meta-analysis and an open repository. Like a meta-analysis, it is centered around a psychologically relevant topic and includes methodological details and ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Journal of Clinical Epidemiology
سال: 2021
ISSN: ['1878-5921', '0895-4356']
DOI: https://doi.org/10.1016/j.jclinepi.2020.12.023