实例-Meta分析评述.ppt

,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Meta-Analysis Critique,The Efficacy of Relapse Prevention on Substance Use Disorders,Ashlee Carter 11/7/05,Reference,Irvin,J.E.,Bowers,C.A.,Dunn,M.E.,&,Wang,M.C.(1999).,Efficacy of Relapse Prevention:A Meta-Analytic Review.,Journal of Consulting and Clinical Psychology,67,563-570.,Research Domain,Clinical Psychology,Therapeutic Interventions,Substance Use Disorders,Alcohol Use,Cocaine Use,Smoking(Tobacco),Polysubstance Use,Central Questions,What is the effect of RP on substance use behavior,What is the effect of RP on overall psychosocial adjustment?,Potential Moderating Variables,Class of substance use disorder,Treatment modality,Setting of treatment,Adjunctive use of medication,Outcome measures,Comparative efficacy of RP,Length of posttreatment follow-up,Methods,Study identification:,Computerized databases,Reference lists,Contact prominent researchers to request unpublished data,Inclusion/Exclusion criteria,Result:26 studies,70 hypothesis tests,9,504 participants,Methods,Main effect sizes converted to,r,Mini meta-analysis within studies,r,transformed to Fishers,z,Weighted average,z,score calculated,z,converted back to,r,Aggregate,r,across studies,95%CI calculated,Weighted average,r,Results,Overall treatment effect of RP interventions for alcohol use disorders,substance use disorders,and smoking is,r,=.14(95%CI=.10 .17,n=22).,Overall treatment effect of RP interventions on improving psychosocial adjustment is,r,=.48(95%CI=.42 to.53,n=10).,Results:File drawer bias?,Fail-safe n=388(p=0.05),Number of undiscovered studies averaging no effect of RP interventions that would be required to reduce the obtained relationship to zero,Conclusion:The main effect is tolerant to future undiscovered null results,Results:Moderator Analysis,Contrast analyses,Z scores,Problems:,Small sample sizes,Differences in effect sizes due to class of substance use disorder,Medication varies,Results:Moderating Variables,1),M,ore effective in treating alcohol and polysubstance use than smoking or cocaine use.,2),E,qually effective in group and individual formats.,3),E,qually effective in outpatient and inpatient formats.,4),M,ore effective with adjunctive medication than without.,5),R,eported more effective in studies that used self-report versus biochemically validated self-report measures.,Results:Moderating Variables,6),E,ffective when evaluated with pretest-posttest designs and when compared to physician advice;only moderately effective when compared with psychoeducational groups or discussion controls.,7),T,reatment effects were largest when outcomes were assessed immediately following treatment and tended to become smaller as the length of follow-up increased.,Conclusions:Done well,Large sample of studies,Appropriate methods,Weighted averaged,r,Mini meta-analysis in,z,Methods clearly outlined,Formulas included,Table,Original statistic included,Coding for moderator clearly described,Conclusions:Done well,Dot Plot,General progression of effect size,No gaps Published and unpublished studies,File drawer bias addressed,Statistics consistently presented,Limitations admitted,Conclusions:Questionable?,Study identification method,Publication bias?,Study rigor?,Moderator analyses,Small sample sizes,Adjustment of alpha levels?,Interpretable?,