Toward empirical identification of a clinically meaningful indicator of treatment outcome: Features of candidate indicators and evaluation of sensitivity to treatment effects and relationship to one year follow up cocaine use outcomes

被引：80

作者：

Carroll, Kathleen M. ^{[1
]}

Kiluk, Brian D. ^{[1
]}

Nich, Charla ^{[1
]}

DeVito, Elise E. ^{[1
]}

Decker, Suzanne ^{[1
,2
]}

LaPaglia, Donna ^{[1
]}

Duffey, Dianne ^{[1
]}

Babuscio, Theresa A. ^{[1
]}

Ball, Samuel A. ^{[1
,3
]}

机构：

[1] Yale Univ, Sch Med, Dept Psychiat, West Haven, CT 06516 USA

[2] New England Mental Illness Res Educ & Clin Ctr, VA Connecticut Healthcare Syst, Storrs, CT USA

[3] APT Fdn, New Haven, CT 06511 USA

来源：

DRUG AND ALCOHOL DEPENDENCE | 2014年 / 137卷

关键词：

Treatment outcome indicators; Randomized trials; Cocaine use disorders; Follow-up studies; COGNITIVE-BEHAVIORAL THERAPY; ADDICTION SEVERITY INDEX; ABUSE-TREATMENT PATIENTS; ALCOHOL TREATMENT; SMOKING-CESSATION; MISSING DATA; SELF-REPORT; DRUG-USE; MULTIPLE IMPUTATION; DRINKING OUTCOMES;

D O I：

10.1016/j.drugalcdep.2014.01.012

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background: Selection of an appropriate indictor of treatment response in clinical trials is complex, particularly for the various illicit drugs of abuse. Most widely used indicators have been selected based on expert group recommendation or convention rather than systematic empirical evaluation. Absence of an evidence-based, clinically meaningful index of treatment outcome hinders cross-study evaluations necessary for progress in addiction treatment science. Method: Fifteen candidate indicators used in multiple clinical trials as well as some proposed recently are identified and discussed in terms of relative strengths and weaknesses (practicality, cost, verifiability, sensitivity to missing data). Using pooled data from five randomized controlled trials of cocaine dependence (N = 434), the indicators were compared in terms of sensitivity to the effects of treatment and relationship to cocaine use and general functioning during follow-up. Results: Commonly used outcome measures (percent negative urine screens; percent days of abstinence) performed relatively well in that they were sensitive to the effects of the therapies evaluated. Others, including complete abstinence and reduction in frequency of use, were less sensitive to effects of specific therapies and were very weakly related to cocaine use or functioning during follow-up. Indicators more strongly related to cocaine use during follow-up were those that reflected achievement of sustained periods of abstinence, particularly at the end of treatment. Conclusions: These analyses did not demonstrate overwhelming superiority of any single indicator, but did identify several that performed particularly poorly. Candidates for elimination included retention, complete abstinence, and indicators of reduced frequency of cocaine use. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

引用

页码：3 / 19

页数：17