Central Queensland Mental Health, Alcohol and Other Drugs Services (CQMHAODS), Base Hospital, Rockhampton, Queensland, Australia; Faculty of Medicine, The University of Queensland Rural Clinical School, Rockhampton, Queensland, Australia.
Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Asian J Psychiatr. 2019 Aug;44:29-34. doi: 10.1016/j.ajp.2019.07.006. Epub 2019 Jul 5.
Non-invasive brain stimulation (NIBS) techniques have emerged as a promising tool for understanding and treating psychiatric disorders, necessitating a caution in terms of interpreting research results.
This study aimed at systematically evaluating a representative sample of research conducted using NIBS interventions in neuro-psychiatric conditions, and assessing the power these studies achieved, given their sample sizes.
A database search was conducted with defined keyword combinations. Using reported summary effects of the meta-analyses as estimate of the true effects, we calculated achieved power of each individual study to detect the effect indicated by the corresponding meta-analysis.
Findings suggest that mean and median powers in the field of NIBS were 0.50, with a mode at 0.83 (range 0.05-1.00). When analysed separately, the median powers were 0.27 for tDCS, 0.70 for TMS and 0.97 for ECT. These studies had a mean total sample size of 22.2 ± 24.9 subjects and the median reported effect size across all studies was 0.61.
According to our findings, studies conducted in NIBS miss around 50% of true positive results. Further, it appears that most of the researchers in this field chase statistical significance with small sample sizes, thus compromising the quality of their conclusions.
非侵入性脑刺激(NIBS)技术已成为理解和治疗精神疾病的有前途的工具,因此需要谨慎解释研究结果。
本研究旨在系统评估使用 NIBS 干预治疗神经精神疾病的代表性研究样本,并根据其样本量评估这些研究获得的效力。
使用定义的关键字组合进行数据库搜索。我们使用报告的荟萃分析汇总效应作为真实效应的估计值,计算了每个单独研究检测相应荟萃分析所指示效应的实际效力。
研究结果表明,NIBS 领域的平均和中位数效力为 0.50,模式为 0.83(范围为 0.05-1.00)。分别分析时,tDCS 的中位数效力为 0.27,TMS 为 0.70,ECT 为 0.97。这些研究的总样本量平均为 22.2±24.9 例,所有研究报告的中位数效应大小为 0.61。
根据我们的发现,NIBS 中的研究错过了大约 50%的真实阳性结果。此外,似乎该领域的大多数研究人员都在用小样本量追求统计学意义,从而影响了他们结论的质量。