Department of Psychology, University of California, Los Angeles 1285 Franz Hall, Los Angeles, CA, 90095, USA.
Department of Psychology, University of California, Los Angeles 1285 Franz Hall, Los Angeles, CA, 90095, USA.
Behav Res Ther. 2017 Mar;90:147-158. doi: 10.1016/j.brat.2016.12.011. Epub 2016 Dec 23.
This review included 136 published randomized controlled trials (RCTs) of youth cognitive behavioral therapy (CBT) treatments. We aimed to test the premise that evidence-based youth treatments can be better differentiated from each other by applying more nuanced standards of evidence. Accordingly, we applied three standards to this article sample to determine how many treatments produced significant results: (a) on multiple target symptom measures, (b) at follow-up, and/or (c) against an active comparison group. We identified how many trials met standards individually and in combination. Although 87 of the 136 articles produced at least one significant treatment result at post-assessment, the subsets of "passing" articles were smaller and varied for any one of our three standards, with only 11 articles (8%) meeting all three standards simultaneously. Implications are discussed regarding the definition of "evidence-based," the need for multi-parameter filtering in treatment selection and clinical decision making, and future directions for research. We ultimately argue the value in assessing youth treatments for different types of evidence, which is better achieved through dynamic sets of standards, rather than a single approach to assessing general strength of evidence.
本综述纳入了 136 项已发表的青少年认知行为疗法 (CBT) 治疗的随机对照试验 (RCT)。我们旨在通过应用更细致的证据标准来检验以下前提，即基于证据的青少年治疗方法可以彼此更好地区分。因此，我们将这篇文章中的样本应用了三个标准，以确定有多少治疗方法产生了显著的效果：(a) 在多个目标症状测量上，(b) 在随访时，和/或 (c) 与积极对照组相比。我们确定了每个标准和组合分别有多少试验符合标准。尽管 136 篇文章中有 87 篇在评估后至少产生了一个显著的治疗结果，但“通过”标准的文章子集较小，并且对于我们的三个标准中的任何一个都有所不同，只有 11 篇文章（8%）同时符合所有三个标准。讨论了关于“基于证据”的定义、在治疗选择和临床决策中进行多参数过滤的必要性，以及未来研究的方向。我们最终认为评估青少年治疗方法的不同类型的证据是有价值的，这可以通过动态的标准集来更好地实现，而不是采用单一方法来评估一般证据强度。
