ArticleInternational journal of bipolar disorders2015
Who will benefit from antidepressants in the acute treatment of bipolar depression? A reanalysis of the STEP-BD study by Sachs et al. 2007, using Q-learning.
Article in International journal of bipolar disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Statistical design and analysis in trials of proportionate interventions: a systematic review.Trials · 2019Pooled it
- Association between dynamic dose increases of buprenorphine for treatment of opioid use disorder and risk of relapse.Addiction (Abingdon, England) · 2022Trial
- Pharmacotherapy in Comorbid Bipolar Disorder and Post-Traumatic Stress Disorder From the STEP-BD Cohort.Bipolar disorders · 2025Article
- Monte Carlo sensitivity analysis for unmeasured confounding in dynamic treatment regimes.Biometrical journal. Biometrische Zeitschrift · 2023Observational
- Understanding heterogeneity of responses to, and optimizing clinical efficacy of, exercise training in older adults: NIH NIA Workshop summary.GeroScience · 2023Review
- Estimation and Optimization of Composite Outcomes.Journal of machine learning research : JMLR · 2021Article
- Bayesian Nonparametric Policy Search with Application to Periodontal Recall Intervals.Journal of the American Statistical Association · 2020Article
- The Effectiveness of Web-Based Tailored Smoking Cessation Interventions on the Quitting Process (Project Quit): Secondary Analysis of a Randomized Controlled Trial.Journal of medical Internet research · 2018Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is substantial uncertainty regarding the efficacy of antidepressants in the treatment of bipolar disorders.
methodsTraditional randomized controlled trials and statistical methods are not designed to discover if, when, and to whom an intervention should be applied; thus, other methodological approaches are needed that allow for the practice of personalized, evidence-based medicine with patients with bipolar depression.
resultsDynamic treatment regimes operationalize clinical decision-making as a sequence of decision rules, one per stage of clinical intervention, that map patient information to a recommended treatment. Using data from the acute depression randomized care (RAD) pathway of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study, we estimate an optimal dynamic treatment regime via Q-learning.
conclusionsThe estimated optimal treatment regime presents some evidence that patients in the RAD pathway of STEP-BD who experienced a (hypo)manic episode before the depressive episode may do better to forgo adding an antidepressant to a mandatory mood stabilizer.
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