Dunn G, Maracy M, Dowrick C, Ayuso-Mateos J L, Dalgard O S, Page H, Lehtinen V, Casey P, Wilkinson C, Vazquez-Barquero J L, Wilkinson G
Biostatistics Group, School of Epidemiology & Health Sciences, University of Manchester, UK.
Br J Psychiatry. 2003 Oct;183:323-31. doi: 10.1192/bjp.183.4.323.
The Outcomes of Depression International Network (ODIN) trial evaluated the effect of two psychological interventions for the treatment of depression in primary care. Only about half of the patients in the treatment arm complied with the offer of treatment, prompting the question:'what was the effect of treatment in those patients who actually received it?'
To illustrate the estimation of the effect of receipt of treatment in a randomised controlled trial subject to non-compliance and loss to follow-up.
We estimated the complier average causal effect (CACE) of treatment.
In the ODIN trial the effect of receipt of psychological intervention (an average of about 4 points on the Beck Depression Inventory) is about twice that of offering it.
The statistical analysis of the results of a clinical trial subject to non-compliance to allocated treatment is now reasonably straightforward through estimation of a CACE and investigators should be encouraged to present the results of analyses of this type as a routine component of a trial report.
抑郁症国际网络（ODIN）试验评估了两种心理干预措施对初级保健中抑郁症治疗的效果。治疗组中只有约一半的患者接受了提供的治疗，这引发了一个问题：“实际接受治疗的患者的治疗效果如何？”
说明在存在不依从和失访情况的随机对照试验中，对接受治疗效果的估计。
我们估计了治疗的依从者平均因果效应（CACE）。
在ODIN试验中，接受心理干预的效果（贝克抑郁量表平均约4分）约为提供心理干预效果的两倍。
通过估计CACE，对存在不依从分配治疗情况的临床试验结果进行统计分析现在相当直接，应鼓励研究者将此类分析结果作为试验报告的常规组成部分呈现。
