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DC Field | Value | Language |
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dc.contributor.author | Cipriani, Andrea | - |
dc.date.accessioned | 2021-08-24T10:01:05Z | - |
dc.date.available | 2021-08-24T10:01:05Z | - |
dc.date.issued | 2021-08 | - |
dc.identifier.citation | Stefan Leucht, Spyridon Siafis, Rolf R Engel, Johannes Schneider-Thoma, Irene Bighelli, Andrea Cipriani, Toshi A Furukawa, John M Davis, How Efficacious Are Antipsychotic Drugs for Schizophrenia? An Interpretation Based on 13 Effect Size Indices, Schizophrenia Bulletin, 2021;, sbab094, | en |
dc.identifier.uri | https://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/934 | - |
dc.description | Contact the library for a copy of this article | en |
dc.description.abstract | Background The magnitude of the superiority of antipsychotics over placebo is debated. One reason is that the effect-size index which is usually used in meta-analyses is in standard deviation units. Many other indices, some of which are more intuitive, exist. Methods We explain the formulae, advantages, and limitations of 13 effect-size indices: Mean Difference (MD), Standardized-Mean-Difference (SMD), Correlation Coefficient, Ratio-of-Means (RoM, endpoint and change data), Improvement Fraction (IF), Drug-Response Fraction (DRF), Minimally-Clinically-Important-Difference-Units (MCIDU), Number-Needed-to-Treat-derived from SMD (NNT), Odds Ratio (OR), Relative Risk (RR), and Risk Difference (RD) derived from SMD, Drug-response and Placebo-response in percent. We applied these indices to meta-analyses comparing antipsychotic drugs with placebo for acute schizophrenia. Results The difference of all antipsychotics pooled vs placebo (105 trials with 22741 participants) was: MD 9.4 (95% CI 8.4,10.2) PANSS points, SMD 0.47 (0.42,0.51), Correlation coefficient 0.23 (0.21,0.25), RoM endpoint 0.83 (0.81,0.85), RoM change 1.94 (1.84,2.02), IF (%) 49 (46,51), DRF (%) 94 (84,102), MCIDU 0.63 (0.56,0.68), NNT 5 (5,6), OR 2.34 (2.14, 2.52), RR 1.67 (1.59,1.73), RD 20% (18–22), and 50% (48, 52) improved on drug compared to 30% on placebo. Results of individual drugs compared to placebo are presented, as well. Conclusions Taken together these indices show a substantial, but not a large superiority of antipsychotics compared to placebo. The general chronicity of the patients in the trials must be considered. Future meta-analyses should report other effect size indices in addition to the Standardized-Mean-Difference, in particular percentage responders in the drug and placebo groups. They can be easily derived and would enhance the interpretation of research findings. | en |
dc.description.sponsorship | Supported by the NIHR | en |
dc.description.uri | https://doi.org/10.1093/schbul/sbab094 | en |
dc.language.iso | en | en |
dc.subject | Schizophrenia | en |
dc.subject | Antipsychotics | en |
dc.title | How Efficacious Are Antipsychotic Drugs for Schizophrenia? An Interpretation Based on 13 Effect Size Indices | en |
dc.type | Article | en |
Appears in Collections: | Schizophrenia and Psychotic Disorders |
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