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治疗突发数据点与单病例设计研究:一种用于估计治疗效应大小的贝叶斯单病例分析

Treatment Burst Data Points and Single Case Design Studies: A Bayesian N-of-1 Analysis for Estimating Treatment Effect Size.

作者信息

Barnard-Brak Lucy, Richman David M, Watkins Laci

机构信息

University of Alabama, Capital Hall 1807, Box 870232, Tuscaloosa, AL 35487 USA.

Texas Tech University, Lubbock, TX USA.

出版信息

Perspect Behav Sci. 2020 May 26;43(2):285-301. doi: 10.1007/s40614-020-00258-8. eCollection 2020 Jun.

Abstract

Single-case experimental designs (SCED) evaluate treatment effects for each participant, but it is difficult to aggregate and quantify treatment effects across SCED participants receiving the same type of treatment. We applied Bayesian analytic procedures to SCED data aggregated across participants that have previously only been applied to large- and group design studies of treatment effect sizes. For the current study, we defined transient elevated treatment data points as (1) above the range of the last five baseline sessions during the first three sessions of treatment (i.e., extinction burst); (2) within or above the range of baseline after the first three treatment sessions (i.e., recurrence burst); or (3) thinning phase data points above the last three prethinning treatment data points (i.e., thinning burst). Results indicated that the treatment effect sizes remained large regardless of controlling for transient elevated treatment data points. Finally, we examined the effects of reinforcer schedule thinning on estimates of treatment effect size. Results indicated a moderate negative impact of schedule thinning on treatment effect size with a 16% decrease in effect size. Recommendations for research and practice are provided, and the utility of using Bayesian analysis in single-case experimental designs is discussed.

摘要

单病例实验设计(SCED)评估每个参与者的治疗效果,但对于接受相同类型治疗的SCED参与者,很难汇总和量化治疗效果。我们将贝叶斯分析程序应用于跨参与者汇总的SCED数据,此前这些程序仅应用于治疗效应大小的大型和组设计研究。在当前研究中,我们将短暂升高的治疗数据点定义为:(1)在治疗的前三节中高于最后五个基线节段的范围(即消退爆发);(2)在前三节治疗后处于或高于基线范围(即复发爆发);或(3)在变薄阶段的数据点高于最后三个变薄前治疗数据点(即变薄爆发)。结果表明,无论是否控制短暂升高的治疗数据点,治疗效应大小仍然很大。最后,我们研究了强化时间表变薄对治疗效应大小估计的影响。结果表明,时间表变薄对治疗效应大小有中度负面影响,效应大小下降了16%。提供了研究和实践建议,并讨论了在单病例实验设计中使用贝叶斯分析的效用。

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