Systematic Review and Meta-analysis:An Empirical Approach to Defining Treatment Response and Remission in Pediatric Obsessive-Compulsive Disorder
| Autor: | Jessica A. Johnson, Fernando R. Asbahr, Michael H. Bloch, Wayne K. Goodman, Michelle Rozenman, Brent J. Small, Eva Serlachius, Divya Ramakrishnan, Cynthia Turner, Adam B. Lewin, Eric A. Storch, Luis C. Farhat, Edoardo F.Q. Vattimo, David Mataix-Cols, Jennifer B. Freeman, John Piacentini, Mohammad Shabani, Gudmundur Skarphedinsson, Angeli Landeros-Weisenberger, Fenghua Li, Daniel Fatori, Fabian Lenhard, Jessica L.S. Levine, Tara S. Peris, Paul Grant, Lisa J. Merlo, Tord Ivarsson, Roseli G. Shavitt, Martin E. Franklin, Daniel A. Geller, Per Hove Thomsen, Bekir B. Artukoglu, Isobel Heyman, Ana I. Rosa-Alcázar, Sandra L. Cepeda, Jonathan S. Comer, Ángel Rosa-Alcázar, Bernhard Weidle, Euripedes Constantino Miguel, Susan E. Swedo, Hamid Mohsenabadi, Jeffrey Sapyta |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Treatment response Obsessive-Compulsive Disorder Youden's J statistic CY-BOCS PsycINFO law.invention Randomized controlled trial law Internal medicine Developmental and Educational Psychology medicine Raw score Humans Child business.industry Area under the curve diagnostic test accuracy Clinical trial meta-analysis obsessive-compulsive disorder Psychiatry and Mental health Research Design Meta-analysis randomized controlled trials business |
| Zdroj: | Farhat, L C, Vattimo, E F Q, Ramakrishnan, D, Levine, J L S, Johnson, J A, Artukoglu, B B, Landeros-Weisenberger, A, Asbahr, F R, Cepeda, S L, Comer, J S, Fatori, D, Franklin, M E, Freeman, J B, Geller, D A, Grant, P J, Goodman, W K, Heyman, I, Ivarsson, T, Lenhard, F, Lewin, A B, Li, F, Merlo, L J, Mohsenabadi, H, Peris, T S, Piacentini, J, Rosa-Alcázar, A I, Rosa-Alcázar, À, Rozenman, M, Sapyta, J J, Serlachius, E, Shabani, M J, Shavitt, R G, Small, B J, Skarphedinsson, G, Swedo, S E, Thomsen, P H, Turner, C, Weidle, B, Miguel, E C, Storch, E A, Mataix-Cols, D & Bloch, M H 2022, ' Systematic Review and Meta-analysis : An Empirical Approach to Defining Treatment Response and Remission in Pediatric Obsessive-Compulsive Disorder ', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 61, no. 4, pp. 495–507 . https://doi.org/10.1016/j.jaac.2021.05.027 |
| Popis: | Objective A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children’s Yale−Brown Obsessive-Compulsive Scale (CY-BOCS) in determining response and remission. We also aimed to generate empirically derived cutoffs on the CY-BOCS for these outcomes. Method A systematic review of PubMed, PsycINFO, Embase and CENTRAL identified 5,401 references; 42 randomized controlled clinical trials were considered eligible, and 21 provided data for inclusion (N 1,234). Scores of ≤2 in the Clinical Global Impressions Improvement and Severity scales were chosen to define response and remission, respectively. A 2-stage, random-effects meta-analysis model was established. The area under the curve (AUC) and the Youden Index were computed to indicate the discriminative ability of the CY-BOCS and to guide for the optimal cutoff, respectively. Results The CY-BOCS had sufficient discriminative ability to determine response (AUC = 0.89) and remission (AUC = 0.92). The optimal cutoff for response was a ≥35% reduction from baseline to posttreatment (sensitivity = 83.9, 95% CI = 83.7−84.1; specificity = 81.7, 95% CI = 81.5−81.9). The optimal cutoff for remission was a posttreatment raw score of ≤12 (sensitivity = 82.0, 95% CI = 81.8−82.2; specificity = 84.6, 95% CI = 84.4−84.8). Conclusion Meta-analysis identified empirically optimal cutoffs on the CY-BOCS to determine response and remission in pediatric OCD randomized controlled clinical trials. Systematic adoption of standardized operational definitions for response and remission will improve comparability across trials for pediatric OCD. |
| Databáze: | OpenAIRE |
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