de Jong Kim, Conijn Judith M, Gallagher Roisin A V, Reshetnikova Alexandra S, Heij Marya, Lutz Miranda C
Institute of Psychology, Leiden University, Leiden, the Netherlands.
Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands.
Clin Psychol Rev. 2021 Apr;85:102002. doi: 10.1016/j.cpr.2021.102002. Epub 2021 Feb 27.
Progress feedback is an intervention aimed at enhancing patient outcomes in routine clinical practice. This study reports a comprehensive multilevel meta-analysis on the effectiveness of progress feedback in psychological treatments in curative care. The short- and long-term effects of feedback on symptom reduction were investigated using 58 (randomized and non-randomized) studies, analyzing 110 effect sizes in a total of 21,699 patients. Effects of feedback on dropout rate, percentage of deteriorated cases, and treatment duration were also examined. Moderation analyses were conducted for study and feedback characteristics. A small significant effect of progress feedback on symptom reduction (d = 0.15, 95% CI: [0.10, 0.20]) was found, compared to control groups. This was also true for not-on-track cases (d = 0.17, 95% CI: [0.11, 0.22]). In addition, feedback had a small favorable effect on dropout rates (OR = 1.19, 95% CI: [1.03, 1.38]). The moderation analyses identified several potentially interesting variables for further research, including feedback instrument, outcome instrument, type of feedback, feedback frequency, treatment intensity, and country in which the study was conducted. Future studies should report on these variables more consistently so that we can obtain a better understanding of when and why feedback improves outcomes.
进展反馈是一种旨在改善常规临床实践中患者治疗效果的干预措施。本研究报告了一项关于进展反馈在治愈性护理心理治疗中的有效性的全面多层次荟萃分析。使用58项（随机和非随机）研究调查了反馈对症状减轻的短期和长期影响，分析了总共21699名患者的110个效应量。还考察了反馈对脱落率、病情恶化病例百分比和治疗持续时间的影响。对研究和反馈特征进行了调节分析。与对照组相比，发现进展反馈对症状减轻有小的显著效果（d = 0.15，95%置信区间：[0.10, 0.20]）。对于未达预期的病例也是如此（d = 0.17，95%置信区间：[0.11, 0.22]）。此外，反馈对脱落率有小的有利影响（优势比 = 1.19，95%置信区间：[1.03, 1.38]）。调节分析确定了几个可能值得进一步研究的有趣变量，包括反馈工具、结果测量工具、反馈类型、反馈频率、治疗强度以及开展研究的国家。未来的研究应更一致地报告这些变量，以便我们能更好地理解反馈何时以及为何能改善治疗效果。
