Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, 0484, Norway.
F1000Res. 2021 Dec 1;10:1221. doi: 10.12688/f1000research.74205.2. eCollection 2021.
A starting point for evaluating the effectiveness of treatments should be to identify evidence gaps. Furthermore, such evaluations should consider the perspectives of patients, clinicians and carers to ensure relevance and potentially influence future research initiatives. Our approach, inspired by the James Lind Alliance methods, involved three steps. First, we performed a document analysis by identifying interventions and outcomes in two recently published overviews of systematic reviews, which summarised the effects of interventions for anxiety and depression in children and adolescents. Second, we surveyed children and adolescents with personal experiences of depression or anxiety as well as clinicians, and asked them to suggest treatments and outcomes associated with uncertainty. Finally, we facilitated a consensus process where clinicians and youth mental health patient representatives were invited to prioritise research uncertainties in separate consensus processes. The survey included 674 respondents who reported a total of 1267 uncertainties. Independent coding by four investigators revealed 134 suggestions for treatments of anxiety, 90 suggestions for treatments of depression, 84 for outcomes of interventions for anxiety and 71 suggestions for outcomes of interventions for depression. Two separate priority setting workshops with eight clinicians and ten youth resulted in four independent top ten priority lists. Top ten lists of treatments and outcome domains of anxiety and depression in children and adolescents was identified by youth and clinicians. The results may influence the research agenda, and ultimately benefit patients.
评估治疗效果的起点应该是确定证据差距。此外，此类评估应考虑患者、临床医生和护理人员的观点，以确保相关性并可能影响未来的研究计划。我们的方法受到詹姆斯·林德联盟方法的启发，分为三个步骤。首先，我们通过确定两项最近发表的系统评价综述中的干预措施和结果，对文件进行了分析，这些综述总结了干预措施对儿童和青少年焦虑和抑郁的影响。其次，我们调查了有抑郁或焦虑个人经历的儿童和青少年以及临床医生，并请他们提出与不确定性相关的治疗方法和结果。最后，我们促进了一个共识过程，邀请临床医生和青少年心理健康患者代表在单独的共识过程中确定研究不确定性的优先级。该调查包括 674 名受访者，他们总共报告了 1267 个不确定性。由四位研究人员进行的独立编码揭示了 134 种焦虑治疗建议、90 种抑郁治疗建议、84 种焦虑干预措施结果建议和 71 种抑郁干预措施结果建议。有 8 名临床医生和 10 名青少年参加的两个单独的优先级设置研讨会产生了四个独立的十大优先事项清单。青少年和临床医生确定了儿童和青少年焦虑和抑郁的十大治疗方法和结果领域清单。研究结果可能会影响研究议程，并最终使患者受益。
