ArticleAtencion primaria2010
[Tree decision analysis of the therapeutic alternatives for Panic Disorders in Primary Care].
Article in Atencion primaria, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
3 authors.
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Abstract
aimsTo analyse the different therapeutic alternatives for Panic Disorders to make it easier to make collaborative treatment decisions between patients and doctors in a Primary Care setting.
designQuantitative analysis by a decision tree. DATA SOURCES: Time period reviewed; 1990-2008 in Med-line, Embase, Cochrane-plus Library and Tripdatabase. Terms used "panic disorder", "psychotherapy" and "drug therapy".
methodsI) A decision tree was prepared with only one therapeutic option in each arm; II) The same procedure with two sequential therapeutic options; III) Sensitivity analysis to test the robustness of the model. STUDY SELECTION: Evidence summary, systematic reviews, meta-analysis and clinical guidelines.
resultsCognitive-Behavioural Therapy (CBT) obtains the highest usefulness (UME=0.58), followed by the Selective serotonin reuptake inhibitors (SSRI) (UME=0.53) and by the tricyclic antidepressants (UME=0.44). CBT followed by SSRI is the therapeutic sequence with the highest usefulness (0.62). The sensitivity analysis suggests the model is not robust enough.
conclusionsThe CBT in monotherapy or followed by SSRI in a sequential strategy would be the options with the highest usefulness. The results are not robust enough because they can clearly vary with changes in the most important variables in a reasonable range.
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