Evidence map›Paper›PMID 28191694›Full record

ArticleAddiction (Abingdon, England)2017

Generalizability of findings from randomized controlled trials: application to the National Institute of Drug Abuse Clinical Trials Network.

Ryoko Susukida, Rosa M Crum, Cyrus Ebnesajjad, Elizabeth A Stuart, Ramin Mojtabai

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Addiction (Abingdon, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 5 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

34 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Addressing Systematic Missing Data in the Context of Causally Interpretable Meta-analysis.Prevention science : the official journal of the Society for Prevention Research · 2023
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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

5 authors.

Ryoko SusukidaDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Rosa M CrumDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Cyrus EbnesajjadDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Elizabeth A StuartDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Ramin MojtabaiDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Funding

Generalizing RCT Efficacy Evidence: Application to NIDA Clinical Trials NetworkR01DA036520 · NIDA · JOHNS HOPKINS UNIVERSITY · PI MOJTABAI, RAMIN · 2014 to 2016
$723k
NIDA NIH HHS R01 DA036520
6 · The paper itself

Abstract

aimsTo compare randomized controlled trial (RCT) sample treatment effects with the population effects of substance use disorder (SUD) treatment.

designStatistical weighting was used to re-compute the effects from 10 RCTs such that the participants in the trials had characteristics that resembled those of patients in the target populations. SETTINGS: Multi-site RCTs and usual SUD treatment settings in the United States.

participantsA total of 3592 patients in 10 RCTs and 1 602 226 patients from usual SUD treatment settings between 2001 and 2009. MEASUREMENTS: Three outcomes of SUD treatment were examined: retention, urine toxicology and abstinence. We weighted the RCT sample treatment effects using propensity scores representing the conditional probability of participating in RCTs.

findingsWeighting the samples changed the significance of estimated sample treatment effects. Most commonly, positive effects of trials became statistically non-significant after weighting (three trials for retention and urine toxicology and one trial for abstinence); also, non-significant effects became significantly positive (one trial for abstinence) and significantly negative effects became non-significant (two trials for abstinence). There was suggestive evidence of treatment effect heterogeneity in subgroups that are under- or over-represented in the trials, some of which were consistent with the differences in average treatment effects between weighted and unweighted results.

conclusionsThe findings of randomized controlled trials (RCTs) for substance use disorder treatment do not appear to be directly generalizable to target populations when the RCT samples do not reflect adequately the target populations and there is treatment effect heterogeneity across patient subgroups.

Indexed as

Randomized Controlled Trials as TopicSubstance-Related DisordersAdolescentAdultFemaleHumansMaleMulticenter Studies as TopicTreatment OutcomeUnited StatesYoung AdultGeneralizabilityNational Institute of Drug Abuse Clinical Trials Networkpropensity score weightingrandomized controlled trialssubstance use disorder treatmenttreatment effect heterogeneity

Identifiers

PMID28191694
PMCPMC5461185

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Registered trials

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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.