Lyons Kathleen D, Hart Tessa, Singh Sheel, Wolfberg Jeremy, Whyte John, Wechsler Stephen, Lin Susan H, Fasoli Susan E, Van Stan Jarrad H
Professor, Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA.
Scientist Emerita, Moss Rehabilitation Research Institute, Elkins Park, PA.
Rehabil Oncol. 2024 Oct;42(4):181-197. doi: 10.1097/01.reo.0000000000000373. Epub 2024 Oct 9.
The Rehabilitation Treatment Specification System (RTSS) provides a framework to decompose complex interventions into components, each defined by its known or hypothesized active ingredients. In addition to its value in planning new interventions and understanding existing ones, we suggest it can be used to help interpret findings of clinical trials and plan next steps in a research program. This paper presents an analysis in which we used the RTSS to retrospectively delineate targets and ingredients of an experimental treatment, Behavioral Activation and Problem-Solving (BA/PS), and then examined the attention control condition for overlapping ingredients that could clarify the control condition's unanticipated effects. Our BA/PS intervention had seven treatment components; three were unique to the BA/PS condition, but the attention control condition contained ingredients that mirrored those found in four of the BA/PS components. Our results illuminate the challenges of designing an adequate control condition for behavioral rehabilitation trials among survivors of cancer. This RTSS application was instrumental in refining our conceptual model and preparing for future research. It serves as a model for other cancer rehabilitation researchers, emphasizing the importance of intentional and transparent intervention specification to advance the field.
康复治疗规范系统（RTSS）提供了一个框架，用于将复杂的干预措施分解为各个组成部分，每个组成部分都由其已知或假设的活性成分来定义。除了在规划新干预措施和理解现有干预措施方面具有价值外，我们认为它还可用于帮助解释临床试验的结果并规划研究项目的后续步骤。本文介绍了一项分析，我们使用RTSS回顾性地描绘了一种实验性治疗方法——行为激活与问题解决（BA/PS）的目标和成分，然后检查了注意力控制条件中是否存在可能解释该控制条件意外效果的重叠成分。我们的BA/PS干预有七个治疗成分；其中三个是BA/PS条件所独有的，但注意力控制条件包含的成分与BA/PS四个成分中的成分相似。我们的结果揭示了为癌症幸存者的行为康复试验设计适当对照条件的挑战。这种RTSS应用有助于完善我们的概念模型并为未来研究做好准备。它为其他癌症康复研究人员树立了一个榜样，强调了有意且透明的干预规范对推动该领域发展的重要性。
