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A demonstration of a multi-method variable selection approach for treatment selection: Recommending cognitive-behavioral versus psychodynamic therapy for mild to moderate adult depression

Cohen, Zachary D. ; Kim, Thomas T. ; Van, Henricus L. ; Dekker, Jack J. M. ; Driessen, Ellen

Psychotherapy research, 2020-02, Vol.30 (2), p.137-150 [Periódico revisado por pares]

England: Routledge

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Título:
A demonstration of a multi-method variable selection approach for treatment selection: Recommending cognitive-behavioral versus psychodynamic therapy for mild to moderate adult depression
Autor: Cohen, Zachary D. ; Kim, Thomas T. ; Van, Henricus L. ; Dekker, Jack J. M. ; Driessen, Ellen
Assuntos: Adult ; Averages ; Clinical Decision-Making - methods ; Cognitive Behavioral Therapy ; Cognitive-Behavioural factors ; Decision Support Techniques ; depression ; Depression - diagnosis ; Depressive Disorder - diagnosis ; depressão ; Extraversion ; Female ; Humans ; Male ; medicina de precisão ; Mental depression ; Middle Aged ; Outcome and Process Assessment, Health Care ; Precision Medicine ; Psychodynamic therapy ; Psychological intervention ; Psychotherapy, Psychodynamic ; Retrospective Studies ; seleção de tratamento ; seleção de variáveis ; Severity of Illness Index ; terapia cognitiva comportamental ; terapia psicodinâmica ; treatment selection ; variable selection ; 介入選擇 ; 心理動力治療 ; 精密醫學 ; 認知行為治療 ; 變項選擇
É parte de: Psychotherapy research, 2020-02, Vol.30 (2), p.137-150
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-News-1
ObjectType-Feature-3
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Descrição: Objective: We use a new variable selection procedure for treatment selection which generates treatment recommendations based on pre-treatment characteristics for adults with mild-to-moderate depression deciding between cognitive behavioral (CBT) versus psychodynamic therapy (PDT). Method: Data are drawn from a randomized comparison of CBT versus PDT for depression (N = 167, 71% female, mean-age = 39.6). The approach combines four different statistical techniques to identify patient characteristics associated consistently with differential treatment response. Variables are combined to generate predictions indicating each individual's optimal-treatment. The average outcomes for patients who received their indicated treatment versus those who did not were compared retrospectively to estimate model utility. Results: Of 49 predictors examined, depression severity, anxiety sensitivity, extraversion, and psychological treatment-needs were included in the final model. The average post-treatment Hamilton-Depression-Rating-Scale score was 1.6 points lower (95%CI = [0.5:2.8]; d = 0.21) for those who received their indicated-treatment compared to non-indicated. Among the 60% of patients with the strongest treatment recommendations, that advantage grew to 2.6 (95%CI = [1.4:3.7]; d = 0.37). Conclusions: Variable selection procedures differ in their characterization of the importance of predictive variables. Attending to consistently-indicated predictors may be sensible when constructing treatment selection models. The small N and lack of separate validation sample indicate a need for prospective tests before this model is used.
Editor: England: Routledge
Idioma: Inglês

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A demonstration of a multi-method variable selection approach for treatment selection: Recommending cognitive-behavioral versus psychodynamic therapy for mild to moderate adult depression

Cohen, Zachary D. ; Kim, Thomas T. ; Van, Henricus L. ; Dekker, Jack J. M. ; Driessen, Ellen

England: Routledge

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