Evidence map›Paper›PMID 24143104›Full record

ArticleNeuropsychiatric disease and treatment2013

An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia.

Jinichi Hirano, Koichiro Watanabe, Takefumi Suzuki, Hiroyuki Uchida, Ryosuke Den, Taishiro Kishimoto, Takashi Nagasawa, Yusuke Tomita, Koichiro Hara, Hiromi Ochi and 20 more

Abstract read
In one paragraph

Article in Neuropsychiatric disease and treatment, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Antipsychotic combinations for schizophrenia.The Cochrane database of systematic reviews · 2017
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Jinichi HiranoDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan ; Ohizumi Hospital, Tokyo, Japan.
Koichiro Watanabe
Takefumi Suzuki
Hiroyuki Uchida
Ryosuke Den
Taishiro Kishimoto
Takashi Nagasawa
Yusuke Tomita
Koichiro Hara
Hiromi Ochi
Yoshimi Kobayashi
Mutsuko Ishii
Akane Fujita
Yoshihiko Kanai
Megumi Goto
Hiromi Hayashi
Kanako Inamura
Fumiko Ooshima
Mariko Sumida
Tomoko Ozawa
Kayoko Sekigawa
Maki Nagaoka
Kae Yoshimura
Mika Konishi
Ataru Inagaki
Takuya Saito
Nobutaka Motohashi
Masaru Mimura
Yoshiro Okubo
Motoichiro Kato

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe use of an algorithm may facilitate measurement-based treatment and result in more rational therapy. We conducted a 1-year, open-label study to compare various outcomes of algorithm-based treatment (ALGO) for schizophrenia versus treatment-as-usual (TAU), for which evidence has been very scarce.

methodsIn ALGO, patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were treated with an algorithm consisting of a series of antipsychotic monotherapies that was guided by the total scores in the positive and negative syndrome scale (PANSS). When posttreatment PANSS total scores were above 70% of those at baseline in the first and second stages, or above 80% in the 3rd stage, patients proceeded to the next treatment stage with different antipsychotics. In contrast, TAU represented the best clinical judgment by treating psychiatrists.

resultsForty-two patients (21 females, 39.0 ± 10.9 years-old) participated in this study. The baseline PANSS total score indicated the presence of severe psychopathology and was significantly higher in the ALGO group (n = 25; 106.9 ± 20.0) than in the TAU group (n = 17; 92.2 ± 18.3) (P = 0.021). As a result of treatment, there were no significant differences in the PANSS reduction rates, premature attrition rates, as well as in a variety of other clinical measures between the groups. Despite an effort to make each group unique in pharmacologic treatment, it was found that pharmacotherapy in the TAU group eventually became similar in quality to that of the ALGO group.

conclusionWhile the results need to be carefully interpreted in light of a hard-to-distinguish treatment manner between the two groups and more studies are necessary, algorithm-based antipsychotic treatments for schizophrenia compared well to treatment-as-usual in this study.

Indexed as

algorithmmeasurement-based treatmentopen-label clinical trialschizophreniatreatment-as-usual

Identifiers

PMID24143104
PMCPMC3798204

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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.