SynthesisSchizophrenia bulletin2008
A composite approach that includes dropout rates when analyzing efficacy data in clinical trials of antipsychotic medications.
Synthesis in Schizophrenia bulletin, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Trajectories of psychotic symptoms and fronto-parietal resting state functional connectivity MRI following an antipsychotic trial in medication-naïve first-episode psychosis patients.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- The association of dropout and outcome in trials of antipsychotic medication and its implications for dealing with missing data.Schizophrenia bulletin · 2008Article
- Methodological issues in current antipsychotic drug trials.Schizophrenia bulletin · 2008Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOften, outcomes in clinical trials of antipsychotic medications are examined using last observation carried forward (LOCF). One limitation of LOCF and other common approaches is that they overlook the meaning underpinning trial completion and noncompletion. Noncompletion often relates to lack of drug tolerability. Because long-term treatment is often indicated, noncompletion is an important outcome. An alternative approach is to test the composite hypothesis of the difference between (a) completion rates and (b) efficacy of complete cases. Studies to date have not applied this relatively new method.
objectiveTo illustrate the composite approach, we applied it to a systematic review of studies and compared the results with the reported LOCF analysis.
methodsA systematic search of the Schizophrenia Module of the Cochrane Library and Medline was conducted that identified 127 relevant randomized clinical trials of antipsychotic medications conducted since 1995. Extracted from study reports were the P values of a difference in dropout and the P value of a difference in improvement among complete cases. These P values were combined using standard approaches.
resultsWe identified 11 trials with 5339 participants that provided the necessary information to adequately apply the composite approach. In 2 trials, (18.2%) in which the LOCF results were not significant, the composite results were significant.
conclusionsThe composite approach was more sensitive to change than LOCF and conceptually answers a more relevant question. It is likely that applying the composite approach would change how results of many trials are interpreted.
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Registered trials
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