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Search All Research Studies
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedCrits-Christoph P, Gallop R, Duong L
Repeated assessments of depressive symptoms in randomized psychosocial intervention trials: best practice for analyzing symptom change over time.
Keywords: Depression, Behavioral Health, Research Methodologies
Optional keywords: mental psychotherapy
Summary
The purpose of this study was to investigate the optimal statistical model for analyzing time effects in psychotherapy randomized trials, specifically when the primary outcome involves repeated assessments of depression symptoms. The researchers utilized data from three studies comparing psychotherapy treatments for major depressive disorder. Self-report ratings were used in Study 1 (N=237) and Study 2 (N=100), while clinician ratings were utilized in Study 3 (N=120). Depression symptoms were assessed at every session in Studies 1 and 2 and monthly in Study 3. Time patterns examined included linear, quadratic, cubic, logarithmic transformation of time, piecewise linear, and unstructured models. The researchers found that in Study 1, a logarithmic-linear model demonstrated the best fit. Study 2 found that all models had negligible support compared to the unstructured model, which was the best fitting. In Study 3, although the cubic model displayed the best fit, it was not significantly superior to the log-linear or unstructured model. The study concluded that when evaluating repeated measures of depression symptoms as the primary outcome, trials should consistently compare various time models, including an unstructured model.
Optional keywords: mental psychotherapy
Summary
The purpose of this study was to investigate the optimal statistical model for analyzing time effects in psychotherapy randomized trials, specifically when the primary outcome involves repeated assessments of depression symptoms. The researchers utilized data from three studies comparing psychotherapy treatments for major depressive disorder. Self-report ratings were used in Study 1 (N=237) and Study 2 (N=100), while clinician ratings were utilized in Study 3 (N=120). Depression symptoms were assessed at every session in Studies 1 and 2 and monthly in Study 3. Time patterns examined included linear, quadratic, cubic, logarithmic transformation of time, piecewise linear, and unstructured models. The researchers found that in Study 1, a logarithmic-linear model demonstrated the best fit. Study 2 found that all models had negligible support compared to the unstructured model, which was the best fitting. In Study 3, although the cubic model displayed the best fit, it was not significantly superior to the log-linear or unstructured model. The study concluded that when evaluating repeated measures of depression symptoms as the primary outcome, trials should consistently compare various time models, including an unstructured model.
AHRQ-funded; HS018440
Citation: Crits-Christoph P, Gallop R, Duong L .
Repeated assessments of depressive symptoms in randomized psychosocial intervention trials: best practice for analyzing symptom change over time.
Psychother Res 2023 Feb;33(2):158-72. doi: 10.1080/10503307.2022.2073289.
Keywords: Depression, Behavioral Health, Research Methodologies
Caves Sivaraman JJ, Naumann RB
Estimating the association between mental health disorders and suicide: a review of common sources of bias and challenges and opportunities for US-based research.
The purpose of this review was 1) to illuminate prevalent methodological approaches and estimates of association between mental health diagnoses and suicide from the meta-analytic literature; 2) to discuss key internal and external validity concerns with these estimates; and 3) to highlight some of the unique attributes and challenges in US-based suicide research and opportunities to move the evidence base forward. The authors offered methodological considerations for future research and discussed opportunities made possible by the recent expansion of the US National Violent Death Reporting System to a nationwide registry.
AHRQ-funded; HS000032.
Citation: Caves Sivaraman JJ, Naumann RB .
Estimating the association between mental health disorders and suicide: a review of common sources of bias and challenges and opportunities for US-based research.
Curr Epidemiol Rep 2020 Dec;7(4):352-62. doi: 10.1007/s40471-020-00250-5..
Keywords: Behavioral Health, Research Methodologies
Callejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
O'Neil ME, Harik JM, McDonagh MS
Development of the PTSD-repository: a publicly available repository of randomized controlled trials for posttraumatic stress disorder.
This paper describes the development of a posttraumatic stress disorder (PTSD) repository of randomized controlled trials that will be publicly available for clinical, research, and policy stakeholders. The authors created a preliminary dataset which is maintained by the National Center for PTSD (NCPTSD). They searched multiple databases for studies published 1980 to 2018. A total of 318 RCTS of PTSD interventions that enrolled almost 25,000 participants were included. They abstracted 337 variables across all studies. This paper describes their methods, defines data elements, and explains coding challenges. The data is now publicly available on the NCPTSD website.
AHRQ-funded; 290201500009I.
Citation: O'Neil ME, Harik JM, McDonagh MS .
Development of the PTSD-repository: a publicly available repository of randomized controlled trials for posttraumatic stress disorder.
J Trauma Stress 2020 Aug;33(4):410-19. doi: 10.1002/jts.22520..
Keywords: Behavioral Health, Research Methodologies, Registries
Munger Clary HM, Croxton RD, Allan J
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
This study assessed the willingness of epilepsy patients positively screened for anxiety and/or depression to participate in a research study. A total of 199 patients screened positively during a routine epilepsy screening visit and 154 (77.4%) opted-in for further research assessment. Nearly half of those 199 individuals were already being treated for anxiety and/or depression, with 46.7% receiving neither antidepressants or therapy. Higher depression scores and current treatment were independently associated with opting in. One-quarter reported a past psychiatric hospitalization, but only half of those individuals were currently receiving mental health specialty care.
AHRQ-funded; HS025723.
Citation: Munger Clary HM, Croxton RD, Allan J .
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
Epilepsy Behav 2020 Mar;104(Pt A):106907. doi: 10.1016/j.yebeh.2020.106907..
Keywords: Anxiety, Depression, Behavioral Health, Neurological Disorders, Chronic Conditions, Screening, Diagnostic Safety and Quality, Health Services Research (HSR), Research Methodologies
Gaynes BN, Lux L, Gartlehner G
Defining treatment-resistant depression.
The authors conducted a review for the Centers for Medicare & Medicaid Services and AHRQ to clarify how experts and investigators have defined treatment-resistant depression (TRD) and to review systematically how well this definition comports with TRD definitions in clinical trials through July 5, 2019. They found that no consensus definition existed for TRD. While depressive outcomes and clinical global impressions were commonly measured, functional impairment and quality-of-life tools were rarely used. They recommend stronger approaches to designing and conducting TRD research in order to foster better evidence to translate into clearer guidelines for treating patients with TRD.
AHRQ-funded; 290201500011I.
Citation: Gaynes BN, Lux L, Gartlehner G .
Defining treatment-resistant depression.
Depress Anxiety 2020 Feb;37(2):134-45. doi: 10.1002/da.22968..
Keywords: Depression, Behavioral Health, Evidence-Based Practice, Implementation, Research Methodologies
Broder-Fingert S, Kuhn J, Sheldrick RC
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Researchers describe a study protocol for a large randomized controlled trial using the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions. They apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation. In this paper, they describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.
AHRQ-funded; HS022242.
Citation: Broder-Fingert S, Kuhn J, Sheldrick RC .
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Trials 2019 Dec 16;20(1):728. doi: 10.1186/s13063-019-3853-y..
Keywords: Research Methodologies, Health Services Research (HSR), Healthcare Delivery, Behavioral Health, Evidence-Based Practice, Access to Care
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Shaffer JA, Kronish IM, Falzon L
N-of-1 randomized intervention trials in health psychology: a systematic review and methodology critique.
The purpose of this study was to assess the quality of the methods and statistics, to describe interventions and outcomes, and to explore the heterogeneity of treatment effect of health psychology N-of-1, or single-case randomized clinical trials. Researchers conducted a systematic review of N-of-1 trials by searching numerous databases from their respective inception up to June 2015; studies were included if they had health behavior or psychological outcomes and the order of interventions was randomized. Study characteristics and analytic methods were then abstracted. The results of the study indicate that N-of-1 randomized trials could become the next major advance in health psychology for precision therapeutics, but they must be conducted with more methodologic and statistical rigor as well as be transparently and fully reported.
AHRQ-funded; HS024262.
Citation: Shaffer JA, Kronish IM, Falzon L .
N-of-1 randomized intervention trials in health psychology: a systematic review and methodology critique.
Ann Behav Med 2018 Aug 16;52(9):731-42. doi: 10.1093/abm/kax026..
Keywords: Behavioral Health, Health Services Research (HSR), Research Methodologies
Cosgrove L, Krimsky S, Wheeler EE
Conflict of interest policies and industry relationships of guideline development group members: A cross-sectional study of clinical practice guidelines for depression.
The purpose of the present study was to assess a) the disclosure requirements of guideline development groups in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. It found that most of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication.
AHRQ-funded; HS022940.
Citation: Cosgrove L, Krimsky S, Wheeler EE .
Conflict of interest policies and industry relationships of guideline development group members: A cross-sectional study of clinical practice guidelines for depression.
Account Res 2017;24(2):99-115. doi: 10.1080/08989621.2016.1251319.
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Keywords: Medication, Depression, Guidelines, Behavioral Health, Research Methodologies
Kahwati L, Viswanathan M, Golin CE
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
The researchers aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. They were able to identify seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 percent) of the effective studies.
AHRQ-funded; HS022563.
Citation: Kahwati L, Viswanathan M, Golin CE .
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
Syst Rev 2016 May 4;5:83. doi: 10.1186/s13643-016-0255-z.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health
Kahwati L, Jacobs S, Kane H
Using qualitative comparative analysis in a systematic review of a complex intervention.
The objective of this study was to describe in detail and examine the suitability of using qualitative comparative analysis (QCA) within the context of a systematic review. It concluded that QCA was suitable for use within a systematic review of medication adherence interventions and offered insights beyond the single dimension stratifications used in the original completed review.
AHRQ-funded; HS022563.
Citation: Kahwati L, Jacobs S, Kane H .
Using qualitative comparative analysis in a systematic review of a complex intervention.
Syst Rev 2016 May 4;5:82. doi: 10.1186/s13643-016-0256-y.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health
Irvin VL, Kaplan RM
AHRQ Author: Kaplan RM
Effect sizes and primary outcomes in large-budget, cardiovascular-related behavioral randomized controlled trials funded by NIH since 1980.
The authors reviewed large-budget, National Institutes of Health (NIH)-supported randomized controlled trials (RCTs) with behavioral interventions to assess (1) publication rates, (2) trial registration, (3) use of objective measures, (4) significant behavior and physiological change, and (5) effect sizes. They concludedc that behavioral trials complied with trial registration standards. Most reported a physiological benefit, but few documented morbidity or mortality benefits.
AHRQ-authored.
Citation: Irvin VL, Kaplan RM .
Effect sizes and primary outcomes in large-budget, cardiovascular-related behavioral randomized controlled trials funded by NIH since 1980.
Ann Behav Med 2016 Feb;50(1):130-46. doi: 10.1007/s12160-015-9739-7.
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Keywords: Outcomes, Cardiovascular Conditions, Research Methodologies, Behavioral Health