实例-Meta分析评述.pptxVIP

Meta-Analysis Critique The Efficacy of Relapse Prevention on Substance Use Disorders Ashlee Carter 11/7/05 Reference Irvin, J.E., Bowers, C.A., Dunn, M.E., Wang, M.C. (1999). Efficacy of Relapse Prevention: A Meta-Analytic Review. Journal of Consulting and Clinical Psychology, 67, 563-570. Research Domain Clinical Psychology Therapeutic Interventions Substance Use Disorders Alcohol Use Cocaine Use Smoking (Tobacco) Polysubstance Use Central Questions What is the effect of RP on substance use behavior What is the effect of RP on overall psychosocial adjustment? Potential Moderating Variables Class of substance use disorder Treatment modality Setting of treatment Adjunctive use of medication Outcome measures Comparative efficacy of RP Length of posttreatment follow-up Methods Study identification: Computerized databases Reference lists Contact prominent researchers to request unpublished data Inclusion/Exclusion criteria Result: 26 studies, 70 hypothesis tests, 9,504 participants Methods Main effect sizes converted to r Mini meta-analysis within studies r transformed to Fisher’s z Weighted average z score calculated z converted back to r Aggregate r across studies 95% CI calculated Weighted average r Results Overall treatment effect of RP interventions for alcohol use disorders, substance use disorders, and smoking is r = .14 (95% CI = .10 – .17, n = 22). Overall treatment effect of RP interventions on improving psychosocial adjustment is r = .48 (95% CI = .42 to .53, n = 10). Results: File drawer bias? Fail-safe n = 388 (p = 0.05) Number of undiscovered studies averaging no effect of RP interventions that would be required to reduce the obtained relationship to zero Conclusion: The main effect is tolerant to future undiscovered null results Results: Moderator Analysis Contrast analyses Z scores Problems: Small sample sizes Differences in effect sizes due to class of substance use disorder Medication varies Results: Moderating Variables 1) More eff