基于网络的反馈干预对超重和肥胖人群的有效性：随机对照试验的系统评价和网络荟萃分析

Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials.

作者信息

Varela Carmen, Oda-Montecinos Camila, Andrés Ana, Saldaña Carmina

机构信息

Department of Clinical Psychology and Psychobiology, Section of Personality, Assessment and Treatment, Faculty of Psychology, University of Barcelona, Passeig Vall d'Hebrón, 171, P.C. 08035, Barcelona, Cataluña, Spain.

Institute of Social Sciences, Universidad de O'Higgins, Rancagua, Chile.

出版信息

J Eat Disord. 2021 Jun 26;9(1):75. doi: 10.1186/s40337-021-00432-6.

DOI:10.1186/s40337-021-00432-6

PMID:34174949

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8234624/

Abstract

BACKGROUND

Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine).

METHOD

From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis.

RESULTS

Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference - 1.86 kg; 95% Confidence Interval: - 3.61, - 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference - 4.31 kg; 95% Confidence Interval: - 5,22, - 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities.

CONCLUSIONS

Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

摘要

背景

基于网络的干预措施已成为治疗肥胖等健康问题的一种创新选择。本系统评价和网络荟萃分析的目的是分析基于网络的行为治疗对超重和肥胖成年人的有效性。基于网络的干预措施和对照干预措施（传统体重控制项目）根据以下反馈特征进行分类：频率、个性化程度和提供者（人工与机器）。

方法

从最初的1789项研究中，本评价纳入了15项研究。进行了网络荟萃分析，以分析基于网络的项目与传统干预措施的疗效，同时考虑直接和间接比较。主要结局是基线与治疗后体重减轻的平均差值（kg）。对异质性和一致性假设进行了验证，以开展网络荟萃分析。

结果

网络荟萃分析显示了不同治疗方案之间的比较。主要结果是，基于密集接触的网络项目比等待名单更有效（平均差值-1.86kg；95%置信区间：-3.61，-0.12）。此外，基于密集接触的网络项目比其他基于网络的方案和自助式传统干预措施更有效。然而，唯一有显著差异的比较是基于密集接触的网络项目与基于引导自助的网络项目（平均差值-4.31kg；95%置信区间：-5.22，-3.41）。根据所得结果，基于密集接触的网络项目是最有效的治疗方案，在网络荟萃分析提供的排名中以98.5%的概率位居第一。