Evidence map›Paper›PMID 23896810›Full record

SynthesisThe American journal of psychiatry2013

Meta-regression analysis of placebo response in antipsychotic trials, 1970-2010.

Ofer Agid, Cynthia O Siu, Steven G Potkin, Shitij Kapur, Eric Watsky, Douglas Vanderburg, Robert B Zipursky, Gary Remington

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The American journal of psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 22 pooled it
8.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 22 syntheses or guidelines pooled it, 136 citations in OpenAlex.

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  12. Study Characteristics Influence the Efficacy of Substance Abuse Treatments: A Meta-analysis of Medications for Smoking Cessation.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020
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  14. Disconnection of drug-response and placebo-response in acute-phase antipsychotic drug trials on schizophrenia? Meta-regression analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2019
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Ofer Agid
Cynthia O Siu
Steven G Potkin
Shitij Kapur
Eric Watsky
Douglas Vanderburg
Robert B Zipursky
Gary Remington
Centre for Addiction and Mental Health · CA

Funding

CIHRMedical Research Council G0701748
6 · The paper itself

Abstract

objectiveLarge placebo response presents a major challenge for psychopharmacologic drug development and contributes to the increasing failure of psychiatric trials. The objective of this meta-regression analysis was to identify potential contributors to placebo response in randomized controlled trials of antipsychotic treatment in schizophrenia.

methodThe authors extracted trial design and clinical variables from eligible randomized controlled trials (N=50) identified through searches of MEDLINE (1960-2010) and other sources. Standardized mean change (SMC) was used as the effect size measure for placebo response, based on change scores on the Brief Psychiatric Rating Scale or the Positive and Negative Syndrome Scale from baseline to endpoint (2 to 12 weeks).

resultsThe results suggest significant heterogeneities (Q=387.83, df=49) in the magnitude of placebo response (mean SMC, -0.33, range -1.4 to 0.9) and in study quality. Both placebo SMC and study quality increased over time. Younger age, shorter duration of illness, greater baseline symptom severity, and shorter trial duration were significantly associated with greater placebo response, while country (United States compared with other countries) was not. More study sites, fewer university or Veterans Affairs treatment settings, and a lower percentage of patients assigned to receive placebo were associated with a greater placebo response, but these were not independent of publication year. Study quality affected the variability but not mean levels of placebo response.

conclusionsThis study identified important patient characteristics and trial design factors affecting the level of placebo response and hence the likelihood of detecting efficacy signals in randomized controlled trials. Future studies should test whether controlling these factors improves the detection of an antipsychotic effect.

Indexed as

Placebo EffectAdultAntipsychotic AgentsFemaleHumansMaleRandomized Controlled Trials as TopicSchizophreniaAntipsychotic Agents

Identifiers

PMID23896810
OpenAlexW2104544216

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.