Department of Women's and Children's Health, Karolinska Institutet, Sweden The National Board of Health and Welfare, Sweden
Department of Women's and Children's Health, Karolinska Institutet, Sweden Center for Psychiatry Research, Stockholm County Council, Sweden.
Autism. 2016 Apr;20(3):295-305. doi: 10.1177/1362361315583817. Epub 2015 May 11.
Systematic reviews have traditionally focused on internal validity, while external validity often has been overlooked. In this study, we systematically reviewed determinants of external validity in the accumulated randomized controlled trials of social skills group interventions for children and adolescents with autism spectrum disorder. We extracted data clustered into six overarching themes: source population, included population, context, treatment provider, treatment intervention, and outcome. A total of 15 eligible randomized controlled trials were identified. The eligible population was typically limited to high-functioning school-aged children with autism spectrum disorder, and the included population was predominantly male and Caucasian. Scant information about the recruitment of participants was provided, and details about treatment providers and settings were sparse. It was not evident from the trials to what extent acquired social skills were enacted in everyday life and maintained over time. We conclude that the generalizability of the accumulated evidence is unclear and that the determinants of external validity are often inadequately reported. At this point, more effectiveness-oriented randomized controlled trials of equally high internal and external validity are needed. More attention to the determinants of external validity is warranted when this new generation of randomized controlled trials are planned and reported. We provide a tentative checklist for this purpose.
系统评价传统上侧重于内部有效性，而外部有效性往往被忽视。在这项研究中，我们系统地回顾了累积的随机对照试验中社交技能团体干预对自闭症谱系障碍儿童和青少年的外部有效性的决定因素。我们提取了数据，将其分为六个总体主题：来源人群、纳入人群、背景、治疗提供者、治疗干预和结果。总共确定了 15 项符合条件的随机对照试验。合格人群通常仅限于高功能学龄自闭症谱系障碍儿童，纳入人群主要为男性和白种人。关于参与者招募的信息很少，关于治疗提供者和环境的细节也很少。从试验中无法看出获得的社交技能在日常生活中得到了多大程度的实施和随着时间的推移得到了多大程度的维持。我们的结论是，累积证据的普遍性尚不清楚，外部有效性的决定因素往往没有得到充分报告。在这一点上，需要更多具有同等内部和外部有效性的以效果为导向的随机对照试验。在计划和报告这新一代随机对照试验时，需要更加关注外部有效性的决定因素。为此，我们提供了一个暂定的清单。
