scholarly journals Some problems with non-inferiority tests in psychotherapy research: psychodynamic therapies as an example

2018 ◽  
Vol 48 (8) ◽  
pp. 1392-1394 ◽  
Author(s):  
Winfried Rief ◽  
Stefan G. Hofmann
Keyword(s):  
Psychotherapy Research ◽  
Lead Author ◽  
Psychological Treatments ◽  
Different Types ◽  
Behavioral Therapies ◽  
Cognitive Behavioral Therapies ◽  
Definition Of ◽  
Meta Analyses ◽  
Psychodynamic Therapies

AbstractIn virtually every field of medicine, non-inferiority trials and meta-analyses with non-inferiority conclusions are increasingly common. This non-inferiority approach has been frequently used by a group of authors favoring psychodynamic therapies (PDTs), concluding that PDTs are just as effective as cognitive-behavioral therapies (CBT). We focus on these examples to exemplify some problems associated with non-inferiority tests of psychological treatments, although the problems also apply to psychopharmacotherapy research, CBT research, and others. We conclude that non-inferiority trials have specific risks of different types of validity problems, usually favoring an (erroneous) non-inferiority conclusion. Non-inferiority trials require the definition of non-inferiority margins, and currently used thresholds have a tendency to be inflationary, not protecting sufficiently against degradation. The use of non-inferiority approaches can lead to the astonishing result that one single analysis can suggest both, superiority of the comparator (here: CBT) and non-inferiority of the other treatment (here PDT) at the same time. We provide recommendations how to improve the quality of non-inferiority trials, and we recommend to consider them among other criteria when evaluating manuscripts examining non-inferiority trials. If psychotherapeutic families (such as PDT and CBT) differ on the number of investigating trials, and in the fields of clinical applications, and in other validity aspects mentioned above, conclusions about their general non-inferiority are no more than a best guess, typically expressing the favored approach of the lead author.

scholarly journals Chronic Diseases and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review

2019 ◽  
Vol 16 (10) ◽  
pp. 1864 ◽  
Author(s):  
Soja Nazarov ◽  
Ulf Manuwald ◽  
Matilde Leonardi ◽  
Fabiola Silvaggi ◽  
Jérôme Foucaud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Return To Work ◽  
Chronic Diseases ◽  
English Language ◽  
Chronic Illnesses ◽  
Language Studies ◽  
Action Project ◽  
Behavioral Therapies ◽  
Cognitive Behavioral Therapies

The increase of chronic diseases worldwide impact quality of life, cause economic and medical costs, and make it necessary to look for strategies and solutions that allow people with chronic diseases (PwCDs) to lead an active working life. As part of the CHRODIS Plus Joint European Action project, a systematic review was conducted to identify studies of interventions that support the maintenance of work and return to work (RTW) among workers with chronic illnesses. These interventions should target employees with the following conditions: diabetes, cardiovascular diseases, metabolic vascular syndrome, respiratory diseases, musculoskeletal disorders, mental disorders, and neurological disorders. An extensive search was performed in PubMed, EMBASE, and PsycINFO for English language studies. Included in this review were 15 randomized controlled trials (RCT) for adult employees (aged 18+). We found that workplace-oriented and multidisciplinary programs are the most supportive to RTW and reducing the absence due to illness. In addition, cognitive behavioral therapies achieve positive results on RTW and sick leave. Finally, coaching is effective for the self-management of chronic disease and significantly improved perceptions of working capacity and fatigue.

scholarly journals CCTV, Risk Management and Regulation Mechanisms in Publicly-Used Places: a Discussion Based on Swiss Examples

2002 ◽  
Vol 2 (2/3) ◽  
Author(s):  
Jean Ruegg ◽  
Valerie November ◽  
Francisco Klauser
Keyword(s):  
Risk Management ◽  
Video Surveillance ◽  
Spatial Relations ◽  
City Centre ◽  
General Context ◽  
Surveillance Systems ◽  
Different Types ◽  
Regulation Mechanisms ◽  
Definition Of

This paper focuses on the relations between different types of actors involved in both conceiving and using video-surveillance systems. More specifically, it deals with the reasons that support the growing use of video-surveillance systems, and the organisation structures and implementation schemes that are designed to cope with them. The analysis raises issues linked to the complexity of social and spatial relations that CCTV tends to produce. Based on four Swiss case studies chosen in function of different objectives (risks), different types of public spaces that are under surveillance (city centre, motorway, industrial zone, public transport), as well as different stages of completion of a CCTV project, the main results are to document new categories of actors: the definition of the relationship between CCTV-providers and end-users must be enlarged. Many more actors are playing important roles in terms of risk management and decision making while designing and implementing CCTV systems. Risks under surveillance: different types of risks are under surveillance. The study is underlining that different forms of surveillance must be distinguished, given the spatial characteristics of every risk (diffuse, located, specific and/or territorialized). The 'distancing effect': CCTV obviously creates distance between the object and the place where surveillance is actually made. To go a bit further, the paper claims that several kinds of distancing effects should be considered. These distancing effects modify both the quality of places under surveillance and the general context where mechanisms can be designed and implemented for a better public regulation of CCTV uses.

First Steps in Beginning a Meta-analysis

2013 ◽  
Author(s):  
Gavin B. Stewart ◽  
Isabelle M. Côté ◽  
Hannah R. Rothstein ◽  
Peter S. Curtis
Keyword(s):  
Field Experiment ◽  
Systematic Approach ◽  
Sampling Error ◽  
Meta Analysis ◽  
Research Synthesis ◽  
Systematic Research ◽  
Different Types ◽  
Statistical Approaches ◽  
Definition Of ◽  
Meta Analyses

This chapter discusses the initiation of the process of systematic research synthesis. Without a systematic approach to defining, obtaining, and collating data, meta-analyses may yield precise but erroneous results, with different types of sampling error (biases) and excess subjectivity in choice of methods and definition of thresholds; these devalue the rigor of any statistical approaches employed. The chapter considers exactly the same issues that face an ecologist designing a field experiment. What's the question? How can I define my sampling universe? How should I collect my data? What analyses should I undertake? How should I interpret my results robustly? These questions are considered in the context of research synthesis.

scholarly journals Robustness Metrics: Consolidating the Multiple Approaches to Quantify Robustness

2016 ◽  
Vol 138 (11) ◽  
Author(s):  
Simon Moritz Göhler ◽  
Tobias Eifler ◽  
Thomas J. Howard
Keyword(s):  
Major Influence ◽  
Design Quality ◽  
Comprehensive Overview ◽  
Different Types ◽  
Final Design ◽  
Definition Of ◽  
Robustness Metrics ◽  
Probability Of Compliance

The robustness of a design has a major influence on how much the product's performance will vary and is of great concern to design, quality, and production engineers. While variability is always central to the definition of robustness, the concept does contain ambiguity, and although subtle, this ambiguity can have significant influence on the strategies used to combat variability, the way it is quantified and ultimately, the quality of the final design. In this contribution, the literature for robustness metrics was systematically reviewed. From the 108 relevant publications found, 38 metrics were determined to be conceptually different from one another. The metrics were classified by their meaning and interpretation based on the types of the information necessary to calculate the metrics. Four different classes were identified: (1) sensitivity robustness metrics; (2) size of feasible design space robustness metrics; (3) functional expectancy and dispersion robustness metrics; and (4) probability of compliance robustness metrics. The goal was to give a comprehensive overview of robustness metrics and guidance to scholars and practitioners to understand the different types of robustness metrics and to remove the ambiguities of the term robustness. By applying an exemplar metric from each class to a case study, the differences between the classes were further highlighted. These classes form the basis for the definition of four specific subdefinitions of robustness, namely the “robust concept,” “robust design,” “robust function,” and “robust product.”

scholarly journals Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results?

2021 ◽  
pp. postgradmedj-2020-139392
Author(s):  
Rachel Wurth ◽  
Michelle Hajdenberg ◽  
Francisco J Barrera ◽  
Skand Shekhar ◽  
Caroline E Copacino ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Scoping Review ◽  
Meta Analysis ◽  
Internal Validity ◽  
Reporting Quality ◽  
Measurement Tool ◽  
Literature Search Strategy ◽  
Definition Of ◽  
Meta Analyses

AimThe aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence.DesignWe conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included.Main outcome measuresWe extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed.ResultsA total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation.ConclusionThe methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.

Contemporary management of keratosis obturans: a systematic review

2021 ◽  
pp. 1-6
Author(s):  
J A Harounian ◽  
V A Patel ◽  
H Isildak
Keyword(s):  
Retrospective Studies ◽  
Final Analysis ◽  
Outcome Instrument ◽  
Randomized Studies ◽  
Published Evidence ◽  
Contemporary Management ◽  
Definition Of ◽  
Meta Analyses

Abstract Objective This study aimed to examine the medical literature regarding the natural history and management of keratosis obturans. Method PubMed was queried via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, and the methodological quality of each study was assessed using the Methodological Index for Non-Randomized Studies criteria. Results Fifty-one studies were abstracted, and dual investigator screening resulted in five retrospective studies for final analysis. All studies included patients afflicted with either unilateral (n = 75) or bilateral keratosis obturans (n = 8). The definition of keratosis obturans was present in three studies: a desquamated keratin plug within the external auditory canal. Mean and median Methodological Index for Non-Randomized Studies scores were 9.5 and 9.5, respectively. All patients underwent keratosis obturans exenteration with microscopy. Two studies reported an outcome instrument to evaluate endpoints: marked stillette and audiometry. No complications were observed with follow-up periods from 3 weeks to 3.5 years. Conclusion This comprehensive review highlights a lack of published evidence relating to keratosis obturans. However, it appears keratosis obturans treatment is safe and efficacious with identifiable clinical practice patterns.

scholarly journals Contextual Cognitive-Behavioral Therapies Across the Psychosis Continuum

2017 ◽  
Vol 22 (2) ◽  
pp. 83-100 ◽  
Author(s):  
Maria João Ruivo Ventura Martins ◽  
Paula Castilho ◽  
Célia Barreto Carvalho ◽  
Ana Telma Pereira ◽  
Vitor Santos ◽  
...  
Keyword(s):  
Dialectical Behavior Therapy ◽  
Risk Of Bias ◽  
Cognitive Behavioral ◽  
Cochrane Library ◽  
Psychotic Symptoms ◽  
Psychosis Continuum ◽  
Compassion Focused Therapy ◽  
Behavioral Therapies ◽  
Cognitive Behavioral Therapies

Abstract. Considering several etiologic, therapeutic, and comorbidity-related factors, a psychosis continuum model has been proposed for the understanding and treatment of psychotic disorders. Within the new emerging treatment approaches, Contextual Cognitive-Behavioral Therapies (CCBT) seem to hold promise for the psychosis continuum. However, considering their novelty for this specific population, the quality of efficacy evidence remains unclear. Objective: To examine, critically analyze, and summarize the results from studies based on therapeutic models within the CCBT approach (Mindfulness and Acceptance-based interventions, Compassion-Focused Therapy, Dialectical Behavior Therapy, and Metacognitive Therapy) for patients with a diagnosis within the psychosis continuum (schizophrenia, schizoaffective disorder, bipolar disorder). Methods: Three leading electronic databases (MEDLINE/PUBMED; PsycINFO; Cochrane Library), a grey literature database (OpenGrey), and registered clinical trials (ClinicalTrials.Gov) were searched using combinations of key terms regarding the CCBT models and the diagnosis considered. Reference lists of the relevant studies and reviews were searched. Only Randomized Controlled Trials (RCTs) were included. The “Cochrane Risk of Bias Assessment Tool” was used for quality assessment. Results: A total of 17 articles were included. This review was based on a majority of unclear or low risk of bias studies. Benefits regarding clinical variables such as psychotic symptoms, anxiety and depression, functioning or quality of life were found. Conclusion: Overall the studies supported some benefits of CCBT approaches for the psychosis continuum. The conceptual perspective on treatment has changed, nevertheless the outcomes assessed are still symptom-focused and there is still need for improvement. Methodological considerations and future directions are presented.

scholarly journals The usefulness and interpretation of systematic reviews

2016 ◽  
Vol 22 (2) ◽  
pp. 132-141 ◽  
Author(s):  
Katharine A. Smith ◽  
Andrea Cipriani ◽  
John R. Geddes
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Critical Appraisal ◽  
Evidence Synthesis ◽  
Scientific Information ◽  
Evidence Based ◽  
Treatment Interventions ◽  
Different Types ◽  
Meta Analyses

SummaryKeeping up to date with the best evidence on treatment interventions is an essential part of clinical practice, but it can seem an overwhelming task for busy clinicians. Systematic reviews and meta-analyses provide a useful and convenient summary of knowledge and form an essential part of an evidence-based approach to clinical practice. However, these reviews vary in methodology and therefore in the quality of the recommendations they provide. Clinicians need to feel confident in their skills of critical appraisal, so that they can assess the relative merits of systematic reviews. In this article we discuss the strengths and limitations of different types of evidence synthesis to enable the reader to feel more confident in assessing the scientific information to use in clinical practice.

scholarly journals Preparedness of Future Physical Education Teachers for Sports-Patriotic Activity

2021 ◽  
Vol 1 (2 (340)) ◽  
pp. 127-138
Author(s):  
Dmytro Pelipas ◽  
Keyword(s):  
Physical Education ◽  
Physical Training ◽  
Physical Education Teachers ◽  
Physical Culture ◽  
Different Types ◽  
Patriotic Education ◽  
Definition Of ◽  
Complex Integral ◽  
Operative Activity

The article deals with the problem of readiness of future physical education teachers to sports-patriotic activity. We examined the emergence and development of the category "readiness" in the studies of psychologists, physiologists, teachers, specialists of physical culture and sport. Different approaches to the definition of readiness for activity in individual researchers are explained by different types of readiness, different types of activity itself and the specificity of a variety of professional specialties. We have determined that the readiness of future physical culture teachers for sports-patriotic activity is a complex, integral category, which consists of psychological, scientific-theoretical, psychophysical and physical training, and is a state of professional mastery of a teacher and the possibility of its implementation in practice with the aim of sports-patriotic education of the younger generation. According to the quality of readiness of future physical culture teachers for sports-patriotic activity, we have defined the following criteria: informational and cognitive; motivational and axiological, reflexive, operative, activity-practical. The determined levels and indicators of future physical education teachers' readiness for sports-patriotic activity: low, medium, high. Further research will focus on the connection of sport-patriotic activity of future physical culture teachers with the aspects of functioning in the conditions of New Ukrainian School.

scholarly journals MODELS OF SECURITY OF POST-QUANTUM ASYMMETRIC ENCUSSION BASED ON INDISTINGUISHABILITY

2019 ◽  
pp. 15-26
Author(s):  
M. V. Yesina ◽  
S. G. Vdovenko ◽  
I. D. Gorbenko
Keyword(s):  
Practical Importance ◽  
Plain Text ◽  
Public Key Cryptosystems ◽  
Quantum Cryptanalysis ◽  
Security Models ◽  
Semantic Security ◽  
Different Types ◽  
Encryption Schemes ◽  
Definition Of

The article takes a verifier of equivalence of the quality of indistinguishability (uncertainty) of the semantic security for the cryptosystems defense against of attacker's cryptanalyses based on matched (selected) open text. The issues of analysis and research of security models of post-quantum cryptoalgorithms in relation to cryptoprimitives of all types, the definition of criteria for assessing their compliance with different security models (according to different types of crypto-transformations) are relevant and of practical importance. The indistinguishability (uncertainty) of encrypted text is an important property of the security of many encryption schemes. The indistinguishability (uncertainty) property when attacking on the basis of matched (selected) plain text is considered a basic requirement for the majority of reliably protected public-key cryptosystems. Some schemes also provide an indistinguishability for attack based on selected (selected) encrypted text and attack based on adaptively picked (selected) encrypted text. The indistinguishability (uncertainty) of an attack on the basis of a selected (selected) open text is equivalent to the properties of semantic security. If the cryptosystem has the property of indistinguishability, the attacker will not be able to distinguish between pairs of encrypted texts based on the message that they encrypt. In the case of non-differentiation (uncertainty) of ciphertext protects all known cryptosystems from the intruder which: is a probabilistic Turing machine of polynomial time; has all algorithms; has full access to communications. Using the property of the indeterminacy (uncertainty) of the encrypted text at the present time, it is guaranteed to protect all known symmetric and asymmetric cryptosystems from the classical or quantum cryptanalysis of the intruder. Here are a review of mostly attacks on the encryption security namely an attack based on adaptively matched (selected) ciphertexts, an attack based on adaptively matched (selected) open texts, an attack based on both of this types of texts, an attack based on matched (selected) ciphertexts, an attack based on matched (selected) open texts and a recognition attacks (recognizability).

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