Bothe Anne K, Davidow Jason H, Bramlett Robin E, Franic Duska M, Ingham Roger J
Department of Communication Sciences and Special Education, The University of Georgia, Athens, GA 30602, USA.
Am J Speech Lang Pathol. 2006 Nov;15(4):342-52. doi: 10.1044/1058-0360(2006/032).
To complete a systematic review, incorporating trial quality assessment, of published research about pharmacological treatments for stuttering. Goals included the identification of treatment recommendations and research needs based on the available high-quality evidence.
Multiple readers reviewed 31 articles published between 1970 and 2005, using a written data extraction instrument developed as a synthesis of existing standards and recommendations. Articles were then assessed using 5 methodological criteria and 4 outcomes criteria, also developed from previously published recommendations.
None of the 31 articles met more than 3 of the 5 methodological criteria (M = 1.74). Four articles provided data to support a claim of short-term improvement in social, emotional, or cognitive variables. One article provided data to show that stuttering frequency was reduced to less than 5%, and 4 additional articles provided data to show that stuttering may have been reduced by at least half. Among the articles that met the trial quality inclusion criterion for the second stage of this review, none provided uncomplicated positive reports.
None of the pharmacological agents tested for stuttering have been shown in methodologically sound reports to improve stuttering frequency to below 5%, to reduce stuttering by at least half, or to improve relevant social, emotional, or cognitive variables. These findings raise questions about the logic supporting the continued use of current pharmacological agents for stuttering.
完成一项系统性综述,纳入试验质量评估,内容为已发表的关于口吃药物治疗的研究。目标包括基于现有高质量证据确定治疗建议和研究需求。
多位读者使用一种书面数据提取工具对1970年至2005年间发表的31篇文章进行了综述,该工具是在综合现有标准和建议的基础上开发的。然后使用同样根据先前发表的建议制定的5项方法学标准和4项结果标准对文章进行评估。
31篇文章中没有一篇符合5项方法学标准中的3项以上(均值 = 1.74)。4篇文章提供了数据以支持社会、情感或认知变量出现短期改善的说法。1篇文章提供的数据表明口吃频率降低到了5%以下,另有4篇文章提供的数据表明口吃可能减少了至少一半。在符合本次综述第二阶段试验质量纳入标准的文章中,没有一篇提供了简单的正面报告。
在方法学合理的报告中,没有一种用于口吃治疗的药物被证明能将口吃频率降低到5%以下,或将口吃减少至少一半,或改善相关的社会、情感或认知变量。这些发现对支持继续使用当前口吃药物的逻辑提出了质疑。