Mount Sinai School of Medicine, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA.
Behav Res Ther. 2010 Jun;48(6):524-30. doi: 10.1016/j.brat.2010.03.001. Epub 2010 Mar 7.
Statistical application of signal detection theory has been used to study the clinical utility of early treatment response in a range of treatments and psychiatric disorders. The current study sought to examine the predictive value of weekly within-treatment drinking using receiver operator curves (ROCs) and zero-inflated Poisson (ZIP) regression in 102 women with alcohol use disorders (AUDs) randomized to either alcohol behavioral individual treatment (ABIT; n = 52) or alcohol behavioral couples treatment (ABCT; n = 50). ROC analyses indicated that failure to achieve or sustain abstinence by the end-of-treatment and one-year follow-up was predicted with reasonable accuracy by week 4 percent days abstinent (PDA) in ABIT. ZIP models yielded similar results with evidence for within-treatment PDA with week 6 PDA predicting both the abstinence as well as percent days drinking at the end-of-treatment and one-year follow-up. Within-treatment PDA was a significantly better predictor of outcomes for ABIT than ABCT, despite a better overall treatment response for ABCT. Implications for stepped care models of alcohol treatment are discussed and recommendations for future research made.
信号检测理论的统计学应用已被用于研究一系列治疗和精神障碍中早期治疗反应的临床效用。本研究旨在通过接受者操作特征曲线（ROC）和零膨胀泊松（ZIP）回归，在 102 名被随机分配到酒精行为个体治疗（ABIT；n=52）或酒精行为夫妻治疗（ABCT；n=50）的酒精使用障碍（AUD）女性中，检查每周治疗内饮酒的预测价值。ROC 分析表明，在 ABIT 中，治疗结束和一年随访时未能达到或维持戒酒的情况，可通过第 4 周的无饮酒天数（PDA）较为准确地预测。ZIP 模型得出了类似的结果，证据表明治疗内 PDA 与第 6 周 PDA 均可预测治疗结束和一年随访时的戒酒率以及饮酒天数。尽管 ABCT 的整体治疗反应更好，但治疗内 PDA 对 ABIT 的预测结果明显优于 ABCT。讨论了酒精治疗的逐步护理模式的意义，并提出了未来研究的建议。
