Hofmann S G, Barlow D H, Papp L A, Detweiler M F, Ray S E, Shear M K, Woods S W, Gorman J M
Phobia Clinic, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, N.Y., USA.
Am J Psychiatry. 1998 Jan;155(1):43-7. doi: 10.1176/ajp.155.1.43.
Whereas the fact of attrition during the course of treatment is well documented, little is known about the factors that affect sample selection before the beginning of a study ("pretreatment attrition"). The present study reports on the degree and sources of pretreatment attrition at two sites of a multicenter study on panic disorder that compared treatment outcomes for imipramine and cognitive behavior therapy.
Data were collected at two clinical research sites, one with a pharmacological treatment orientation (N = 420) and one with a psychosocial treatment orientation (N = 208).
The main source of pretreatment attrition was participant refusal. At both research sites, eligible patients most often refused participation because they were either unwilling to start treatment with imipramine (30.6% and 47.4%, respectively) or discontinue their current medication (22.6% and 35.1%, respectively).
Results from comparative treatment outcome studies are limited not only to people who meet the study criteria but also to those who are willing to begin a medication treatment and discontinue their current medication.
尽管治疗过程中的样本流失情况已有充分记录，但对于研究开始前（“治疗前流失”）影响样本选择的因素却知之甚少。本研究报告了一项关于惊恐障碍的多中心研究中两个研究点的治疗前流失程度及来源，该研究比较了丙咪嗪和认知行为疗法的治疗效果。
在两个临床研究点收集数据，一个以药物治疗为主（N = 420），另一个以社会心理治疗为主（N = 208）。
治疗前流失的主要原因是参与者拒绝。在两个研究点，符合条件的患者最常拒绝参与，原因要么是不愿意开始丙咪嗪治疗（分别为30.6%和47.4%），要么是不愿意停用当前药物（分别为22.6%和35.1%）。
比较治疗效果研究的结果不仅限于符合研究标准的人群，还限于那些愿意开始药物治疗并停用当前药物的人群。
