Prendergast Michael L, Podus Deborah, Chang Eunice, Urada Darren
Integrated Substance Abuse Programs, UCLA Drug Abuse Research Center, Neuropsychiatric Institute, University of California, 11050 Santa Monica Blvd, Suite 150, Los Angeles, CA 90025, USA.
Drug Alcohol Depend. 2002 Jun 1;67(1):53-72. doi: 10.1016/s0376-8716(02)00014-5.
A meta-analysis was conducted on 78 studies of drug treatment conducted between 1965 and 1996. Each study compared outcomes among clients who received drug treatment with outcomes among clients who received either minimal treatment or no treatment. Five methodological variables were significant predictors of effect size. Larger effect sizes were associated with studies with the following characteristics: smaller numbers of dependent variables, significant differences between groups at admission, low levels of attrition in the treatment group, a passive comparison group (no treatment, minimal treatment) as opposed to an active comparison group (standard treatment), and drug use determined by a drug test. Controlling for these methodological variables, further analyses indicated that drug abuse treatment has both a statistically significant and a clinically meaningful effect in reducing drug use and crime, and that these effects are unlikely to be due to publication bias. For substance abuse outcomes, larger effect sizes tended to be found in studies in which treatment implementation was rated high, the degree of theoretical development of the treatment was rated low, or researcher allegiance to the treatment was rated as favorable. For crime outcomes, only the average age of study participants was a significant predictor of effect size, with treatment reducing crime to a greater degree among studies with samples consisting of younger adults as opposed to older adults. Treatment modality and other variables were not related to effect sizes for either drug use or crime outcomes
对1965年至1996年间进行的78项药物治疗研究进行了荟萃分析。每项研究都比较了接受药物治疗的患者与接受极少治疗或未接受治疗的患者的治疗结果。五个方法学变量是效应大小的显著预测因素。效应大小较大与具有以下特征的研究相关:较少的因变量数量、入院时组间存在显著差异、治疗组的低损耗率、作为被动对照组(无治疗、极少治疗)而非主动对照组(标准治疗),以及通过药物测试确定药物使用情况。在控制了这些方法学变量后,进一步分析表明,药物滥用治疗在减少药物使用和犯罪方面具有统计学上的显著意义和临床意义,而且这些效果不太可能是由于发表偏倚。对于药物滥用结果,在治疗实施被评为高、治疗的理论发展程度被评为低或研究人员对治疗的忠诚度被评为有利的研究中,往往发现效应大小较大。对于犯罪结果,只有研究参与者的平均年龄是效应大小的显著预测因素,与样本由老年人组成的研究相比,在样本由年轻人组成的研究中,治疗在更大程度上减少了犯罪。治疗方式和其他变量与药物使用或犯罪结果的效应大小均无关。