Evidence map›Paper›PMID 30958879›Full record

Trial reportThe international journal of neuropsychopharmacology2019

Prediction of Acute-Phase Treatment Outcomes by Adding a Single-Item Measure of Activity Impairment to Symptom Measurement: Development and Validation of an Interactive Calculator from the STAR*D and CO-MED Trials.

Manish K Jha, Charles South, Jay Trivedi, Abu Minhajuddin, A John Rush, Madhukar H Trivedi

Abstract readClinical TrialMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The international journal of neuropsychopharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–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

8 citing papers in PubMed.

  1. Trial
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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

6 authors.

Manish K JhaCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, Texas.
Charles SouthCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, Texas.
Jay TrivediCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, Texas.
Abu MinhajuddinCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, Texas.
A John RushProf Emeritus, Duke-National University of Singapore, Singapore.
Madhukar H TrivediCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, Texas.

Funding

TREATMENT RESISTANT DEPRESSION-278990003N01MH090003 · NIMH · UNIVERSITY OF TEXAS SW MED CTR/DALLAS · 1999 to 2003
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NIMH NIH HHS N01 MH090003
6 · The paper itself

Abstract

backgroundDay-to-day functioning is impaired in major depressive disorder. Yet there are no guidelines to systematically assess these functional changes. This report evaluates prognostic utility of changes in activity impairment to inform clinical decision-making at an individual level.

methodsMixed model analyses tested changes in activity impairment (sixth item of Work and Activity Impairment scale, rated 0-10) at mid-point (week 6) and end of step 1 (weeks 12-14) in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial (n = 2697) after controlling for depression severity [Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR)]. Interactive calculators for end of step 1 remission (QIDS-SR ≤5) and no meaningful benefit (<30% QIDS-SR reduction from baseline) were developed for participants with complete data (n = 1476) and independently replicated in the Combining Medications to Enhance Depression Outcomes trial (n = 399).

resultsActivity impairment improved independently with acute-phase treatment in STAR*D (F = 7.27; df = 2,2625; P < .001). Baseline to mid-point activity impairment change significantly predicted remission (P < .001, model area under the curve = 0.823) and no meaningful benefit (P < .001, area under the curve = 0.821) in the STAR*D trial. Adding activity impairment variables to depression severity measures correctly reclassified 28.4% and 15.8% remitters and nonremitters (net reclassification improvement analysis, P < .001), and 11.4% and 16.8% of those with no meaningful benefit and meaningful benefit (net reclassification improvement analysis, P < .001). The STAR*D trial model estimates accurately predicted remission (area under the curve = 0.80) and no meaningful benefit (area under the curve = 0.82) in the Combining Medications to Enhance Depression Outcomes trial and was used to develop an interactive calculator.

conclusionA single-item self-report measure of activity impairment changes independently with antidepressant treatment. Baseline to week 6 changes in activity impairment and depression severity can be combined to predict acute-phase remission and no meaningful benefit at an individual level.

Indexed as

Activities of Daily LivingAdultAntidepressive AgentsDiagnosis, Computer-AssistedFemaleHumansInternetMajor Depressive DisorderMalePrognosisPsychiatric Status Rating ScalesRemission InductionSelf ReportSeverity of Illness IndexAntidepressive Agentsactivity impairmentantidepressant treatmentmajor depressionmeasurement-based careremissionresponse predictionSTAR*D

Identifiers

PMID30958879
PMCPMC6499251

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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.