Translating treatment research findings into clinical action

The application of basic science research to the development and optimization of psychological treatments holds great potential. However, this process of clinical translation is challenging and time-consuming, and the standard route by which it proceeds is inefficient. Adaptive rolling designs, which originated within cancer treatment research, provide an alternative methodology with potential to accelerate development and optimization of psychological treatments. In such designs, multiple treatment options are tested simultaneously, with sequential Bayesian analyses used to remove poorly performing arms. Further, new treatment arms informed by the latest research findings can be introduced into the existing infrastructure as the trial progresses. These features drastically reduce the sample sizes needed and offer a means for more rapid and efficient clinical translation. This paper outlines the utility of such designs to clinical psychological science, focusing on a new variant termed the ‘leapfrog’ design, and discusses their potential uses to accelerate clinical translation.

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Prevention of conduct disorder before and after school entry: Relating interventions to developmental findings

Development and Psychopathology ◽

10.1017/s0954579400004375 ◽

1993 ◽

Vol 5 (1-2) ◽

pp. 243-262 ◽

Cited By ~ 219

Author(s):

John B. Reid

Keyword(s):

Elementary School ◽

Conduct Disorder ◽

After School ◽

Developmental Approach ◽

The Family ◽

Before And After ◽

Early Elementary School ◽

Research Findings ◽

Treatment Research ◽

Family Setting

AbstractIn this paper, both longitudinal and treatment studies relevant to conduct disorder (CD) are reviewed, and a developmental approach to its prevention is presented. Outcome studies for the treatment of CD and antisocial behavior are first reviewed to demonstrate that, although none have been entirely successful, many interventions have powerful effects on various symptoms that comprise the disorder, highly predictive antecedents, and risk factors. Second, the development of CD and the potency and interrelationship among antecedent and mediating variables is traced through the preschool and early elementary school years. Third, an attempt is made to synthesize the developmental and treatment research findings to suggest possible integrations of interventions that are promising for future preventive trials in the preschool and elementary school periods. It is concluded that, whereas before the entry to school preventive interventions targeted entirely in the family setting may prove successful, after the transition to school multisetting interventions will be essential. Finally, three examples of new and multisetting prevention trials are briefly described.

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Young People's Views on Accelerometer Use in Physical Activity Research: Findings from a User Involvement Investigation

ISRN Obesity ◽

10.5402/2012/948504 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Joanna Kirby ◽

Carly Tibbins ◽

Claire Callens ◽

Beckie Lang ◽

Margaret Thorogood ◽

...

Keyword(s):

Physical Activity ◽

Research Study ◽

User Involvement ◽

Development Stage ◽

Activity Levels ◽

Prevention And Treatment ◽

Research Findings ◽

Treatment Research ◽

The Individual ◽

Study Development

The use of accelerometers to objectively measure physical activity is important in understanding young people's behaviours, as physical activity plays a key part in obesity prevention and treatment. A user-involvement qualitative study with young people aged 7–18 years (n=35) was carried out to investigate views on accelerometer use to inform an obesity treatment research study. First impressions were often negative, with issues related to size and comfort reported. Unwanted attention from wearing an accelerometer and bullying risk were also noted. Other disadvantages included feeling embarrassed and not being able to wear the device for certain activities. Positive aspects included feeling “special” and having increased attention from friends. Views on the best time to wear accelerometers were mixed. Advice was offered on how to make accelerometers more appealing, including presenting them in a positive way, using a clip rather than elastic belt to attach, personalising the device, and having feedback on activity levels. Judgements over the way in which accelerometers are used should be made at the study development stage and based on the individual population. In particular, introducing accelerometers in a clear and positive way is important. Including a trial wearing period, considering practical issues, and providing incentives may help increase compliance.

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Utilizing Alcoholism Treatment Research Findings in Clinical Practice

Alcohol Abuse Treatment ◽

10.1007/978-1-4612-0363-6_8 ◽

1992 ◽

pp. 187-202 ◽

Cited By ~ 1

Author(s):

Richard K. Fuller ◽

Fulton Caldwell ◽

John Allen

Keyword(s):

Clinical Practice ◽

Alcoholism Treatment ◽

Research Findings ◽

Treatment Research

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Introducing the Leapfrog Design: A Simple Bayesian Adaptive Rolling Trial Design for Accelerated Treatment Development and Optimization

Clinical Psychological Science ◽

10.1177/2167702619858071 ◽

2019 ◽

Vol 7 (6) ◽

pp. 1222-1243

Author(s):

Simon E. Blackwell ◽

Marcella L. Woud ◽

Jürgen Margraf ◽

Felix D. Schönbrodt

Keyword(s):

Treatment Options ◽

Science Research ◽

Clinical Translation ◽

Psychological Treatments ◽

Multiple Treatment ◽

Accelerate Development ◽

New Variant ◽

Research Findings ◽

Treatment Research ◽

New Treatment

The application of basic science research to the development and optimization of psychological treatments holds great potential. However, this process of clinical translation is challenging and time-consuming, and the standard route by which it proceeds is inefficient. Adaptive rolling designs, which originated within cancer treatment research, provide an alternative methodology with potential to accelerate development and optimization of psychological treatments. In such designs, multiple treatment options are tested simultaneously, with sequential Bayesian analyses used to remove poorly performing arms. Further, new treatment arms informed by the latest research findings can be introduced into the existing infrastructure as the trial progresses. These features dramatically reduce the sample sizes needed and offer a means for more rapid and efficient clinical translation. This article outlines the utility of such designs to clinical psychological science, focusing on a new variant termed the leapfrog design, and discusses their potential uses to accelerate clinical translation.

Download Full-text

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00171 ◽

2020 ◽

Vol 29 (2) ◽

pp. 688-704

Author(s):

Katrina Fulcher-Rood ◽

Anny Castilla-Earls ◽

Jeff Higginbotham

Keyword(s):

Clinical Practice ◽

Research Evidence ◽

Evidence Based Practice ◽

Evidence Based ◽

Clinical Expertise ◽

Speech Language Pathologists ◽

School Based ◽

Research Findings ◽

Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

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Treatment for Progressive Impairments of Language

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld20.1.13 ◽

2010 ◽

Vol 20 (1) ◽

pp. 13-20 ◽

Cited By ~ 2

Author(s):

Maya Henry

Keyword(s):

Behavioral Treatment ◽

Primary Progressive Aphasia ◽

Sentence Production ◽

Lexical Retrieval ◽

Functional Communication ◽

Language Performance ◽

Communication Techniques ◽

Primary Object ◽

Behavioral Treatments ◽

Treatment Research

Abstract Primary progressive aphasia (PPA) is a relatively new diagnostic entity, for which few behavioral treatments have been investigated. Recent work has helped to clarify the nature of distinct PPA variants, including a nonfluent variant (NFV-PPA), a logopenic variant (LV-PPA), and a semantic variant (SV-PPA). This paper reviews treatment research to date in each subtype of PPA, including restitutive, augmentative, and functional approaches. The evidence suggests that restitutive behavioral treatment can result in improved or stabilized language performance within treated domains. Specifically, sentence production and lexical retrieval have been addressed in NFV-PPA, whereas lexical retrieval has been the primary object of treatment in LV and SV-PPA. Use of augmentative communication techniques, as well as implementation of functional communication approaches, also may result in improved communication skills in individuals with PPA. The ideal treatment approach may be one that combines restitutive, augmentative, and functional approaches to treatment, in order to maximize residual cognitive-linguistic skills in patients. Additional research is warranted to determine which modes of treatment are most beneficial in each type of PPA at various stages of severity.

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