Evidence map›Paper›PMID 27554483›Full record

SynthesisCanadian journal of psychiatry. Revue canadienne de psychiatrie2017

Systematic Review of Clinical Practice Guidelines for Failed Antidepressant Treatment Response in Major Depressive Disorder, Dysthymia, and Subthreshold Depression in Adults.

Glenda MacQueen, Pasqualina Santaguida, Homa Keshavarz, Natalia Jaworska, Mitchell Levine, Joseph Beyene, Parminder Raina

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 7 pooled it
3.7field-weighted citation impact, top 8% 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

56 citing papers in PubMed, 7 syntheses or guidelines pooled it, 121 citations in OpenAlex.

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  19. Effects of social support on adolescent identity development.Journal of emerging investigators · 2024
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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

7 authors at 3 institutions in 1 country.

Glenda MacQueen1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta.
Pasqualina Santaguida2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Homa Keshavarz2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Natalia Jaworska3 Department of Psychiatry, McGill University, Montreal, Quebec.
Mitchell Levine2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Joseph Beyene2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Parminder Raina2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
McMaster University · CAMcGill University · CAUniversity of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review critically evaluated clinical practice guidelines (CPGs) for treating adults with major depressive disorder, dysthymia, or subthreshold or minor depression for recommendations following inadequate response to first-line treatment with selective serotonin reuptake inhibitors (SSRIs).

methodSearches for CPGs (January 2004 to November 2014) in English included 7 bibliographic databases and grey literature sources using CPG and depression as the keywords. Two raters selected CPGs on depression with a national scope. Data extraction included definitions of adequate response and recommended treatment options. Two raters assessed quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.

resultsFrom 46,908 citations, 3167 were screened at full text. From these 21 CPG were applicable to adults in primary care and outpatient settings. Five CPGs consider patients with dysthymia or subthreshold or minor depression. None provides recommendations for those who do not respond to first-line SSRI treatment. For adults with MDD, most CPGs do not define an "inadequate response" or provide specific suggestions regarding how to choose alternative medications when switching to an alternative antidepressant. There is variability between CPGs in recommending combination strategies. AGREE II ratings for stakeholder involvement in CPG development, editorial independence, and rigor of development are domains in which depression guidelines are often less robust.

conclusionsAbout half of patients with depression require second-line treatment to achieve remission. Consistency and clarity in guidelines for second-line treatment of depression are therefore important for clinicians but lacking in most current guidelines. This may reflect a paucity of primary studies upon which to base conclusions.

Indexed as

Antidepressive AgentsDepressionDepressive Disorder, Treatment-ResistantDysthymic DisorderHumansMajor Depressive DisorderPractice Guidelines as TopicAntidepressive Agentsclinical practice guidelinesdepressioninadequate responsesystematic review

Identifiers

PMID27554483
PMCPMC5302110
OpenAlexW2516654568

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.