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运动可减轻患有关节炎的成年人的抑郁症状:证据价值。

Exercise reduces depressive symptoms in adults with arthritis: Evidential value.

作者信息

Kelley George A, Kelley Kristi S

机构信息

Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506-9190, United States.

出版信息

World J Rheumatol. 2016 Jul 12;6(2):23-29. doi: 10.5499/WJR.v6.i2.23.

Abstract

AIM

To determine whether evidential value exists that exercise reduces depression in adults with arthritis and other rheumatic conditions.

METHODS

Utilizing data derived from a prior meta-analysis of 29 randomized controlled trials comprising 2449 participants (1470 exercise, 979 control) with fibromyalgia, osteoarthritis, rheumatoid arthritis or systemic lupus erythematosus, a new method, -curve, was utilized to assess for evidentiary worth as well as dismiss the possibility of discriminating reporting of statistically significant results regarding exercise and depression in adults with arthritis and other rheumatic conditions. Using the method of Stouffer, -scores were calculated to examine selective-reporting bias. An alpha () value < 0.05 was deemed statistically significant. In addition, average power of the tests included in -curve, adjusted for publication bias, was calculated.

RESULTS

Fifteen of 29 studies (51.7%) with exercise and depression results were statistically significant ( < 0.05) while none of the results were statistically significant with respect to exercise increasing depression in adults with arthritis and other rheumatic conditions. Right-skew to dismiss selective reporting was identified ( = -5.28, < 0.0001). In addition, the included studies did not lack evidential value ( = 2.39, = 0.99), nor did they lack evidential value and were -hacked ( = 5.28, > 0.99). The relative frequencies of -values were 66.7% at 0.01, 6.7% each at 0.02 and 0.03, 13.3% at 0.04 and 6.7% at 0.05. The average power of the tests included in -curve, corrected for publication bias, was 69%. Diagnostic plot results revealed that the observed power estimate was a better fit than the alternatives.

CONCLUSION

Evidential value results provide additional support that exercise reduces depression in adults with arthritis and other rheumatic conditions.

摘要

目的

确定是否有证据表明运动能减轻患有关节炎和其他风湿性疾病的成年人的抑郁症状。

方法

利用先前对29项随机对照试验的数据进行的荟萃分析,这些试验包括2449名患有纤维肌痛、骨关节炎、类风湿性关节炎或系统性红斑狼疮的参与者(1470名运动组,979名对照组),采用一种新方法——曲线,来评估证据价值,并排除在患有关节炎和其他风湿性疾病的成年人中,运动与抑郁之间存在统计学显著结果的歧视性报告的可能性。使用斯托弗方法计算z分数,以检查选择性报告偏倚。α(α)值<0.05被视为具有统计学显著性。此外,还计算了经发表偏倚调整后的曲线中所包含试验的平均效能。

结果

29项有运动与抑郁结果的研究中有15项(51.7%)具有统计学显著性(P<0.05),而在患有关节炎和其他风湿性疾病的成年人中,没有结果表明运动增加抑郁具有统计学显著性。发现右偏态以排除选择性报告(z=-5.28,P<0.0001)。此外,纳入的研究不缺乏证据价值(z=2.39,P=0.99),也不缺乏证据价值且未被“p值操纵”(z=5.28,P>0.99)。P值的相对频率在0.01时为66.7%,在0.02和0.03时各为6.7%,在0.04时为13.3%,在0.05时为6.7%。经发表偏倚校正后,曲线中所包含试验的平均效能为69%。诊断图结果显示,观察到的效能估计比其他方法更合适。

结论

证据价值结果进一步支持了运动能减轻患有关节炎和其他风湿性疾病的成年人的抑郁症状这一观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c61/4968945/25778a452715/nihms772216f1.jpg

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