抑郁症治疗系统评价的证据有多可靠及适用性如何：系统审查方案

How trustworthy and applicable is the evidence from systematic reviews of depression treatments: Protocol for systematic examination.

作者信息

Fober Iwo, Baran Lidia, Samara Myrto, Siafis Spyridon, Grimes David Robert, Helfer Bartosz

机构信息

Meta-Research Centre, University of Wroclaw, Wroclaw, Poland.

Institute of Psychology, University of Wroclaw, Wroclaw, Poland.

出版信息

PLoS One. 2025 Jun 6;20(6):e0325384. doi: 10.1371/journal.pone.0325384. eCollection 2025.

DOI:10.1371/journal.pone.0325384

PMID:40478833

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12143501/

Abstract

BACKGROUND

Depression is a common mental disorder significantly impacting daily functioning. Standard treatments include drugs, psychotherapies, or a combination of both. Treatment selection relies on scientific evidence, though the trustworthiness and applicability of this evidence can vary.

OBJECTIVES

This protocol presents a method to evaluate evidence from systematic reviews for pharmacological and psychological treatments for depression, focusing on trustworthiness and applicability structured into five components: quality of conduct and reporting, risk of bias, spin in abstract conclusions, robustness of meta-analytical results, heterogeneity and clinical diversity.

METHODS

We will conduct a systematic search of systematic reviews in MEDLINE, Embase, PsycInfo, and Cochrane Database of Systematic Reviews. Our focus will be on systematic reviews of first-line treatments for depression in adults, including antidepressants, psychotherapy, or combined treatments, compared to either active or inactive comparators. We will extract information needed for a comprehensive methodological evaluation using qualitative tools, including AMSTAR 2, ROBIS, Conflict-of-Interest assessment, Referencing Framework for SRs, Spin Measure, and heterogeneity exploration assessment. For quantitative analyses, such as Fragility Index, Ellipse of Insignificance, Region of Attainable Redaction, GRIM test, Leave-N-Out analysis, and prediction intervals, we will select and recalculate two meta-analyses per review. We define a set of outcomes to enable practical and intuitive interpretation of these analyses' results. Descriptive statistics, non-parametric statistical tests, and narrative summaries will be used to synthesize and compare outcomes across several pre-specified subgroups.

EXPECTED OUTCOMES

We expect these analyses to provide an enhanced perspective on the practice of evidence synthesis in the field of mental health, offer methodological guidance for future systematic reviews and meta-analyses, and contribute to improved informed decision-making by clinicians and patients.

OSF REGISTRATION

osf.io/7f9cj and osf.io/ynejs.

摘要

背景

抑郁症是一种常见的精神障碍，对日常功能有重大影响。标准治疗方法包括药物治疗、心理治疗或两者结合。治疗选择依赖于科学证据，不过该证据的可信度和适用性可能各不相同。

目的

本方案提出一种方法，用于评估抑郁症药物治疗和心理治疗系统评价的证据，重点关注可信度和适用性，分为五个组成部分：实施和报告质量、偏倚风险、摘要结论中的倾向性、Meta分析结果的稳健性、异质性和临床多样性。

方法

我们将在MEDLINE、Embase、PsycInfo和Cochrane系统评价数据库中对系统评价进行系统检索。我们将重点关注成人抑郁症一线治疗的系统评价，包括抗抑郁药、心理治疗或联合治疗，与活性或非活性对照进行比较。我们将使用定性工具提取全面方法学评估所需的信息，包括AMSTAR 2、ROBIS、利益冲突评估、系统评价参考框架、倾向性测量和异质性探索评估。对于定量分析，如脆弱性指数、无意义椭圆、可实现修订区域、GRIM检验、留一法分析和预测区间，我们将为每个评价选择并重新计算两项Meta分析。我们定义一组结局，以便对这些分析结果进行实际且直观的解释。描述性统计、非参数统计检验和叙述性总结将用于综合和比较多个预先指定亚组中的结局。