Estimating the true effectiveness of smoking cessation interventions under variable comparator conditions: A systematic review and meta‐regression.
Background and aims: Behavioural smoking cessation trials have used comparators that vary considerably between trials. Although some previous meta‐analyses made attempts to account for variability in comparators, these relied on subsets of trials and incomplete data on comparators. This study aimed...
| Publicado en: | Addiction Vol. 118; no. 10; pp. 1835 - 1851 |
|---|---|
| Autores principales: | , , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2023
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=171583255&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 171583255 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Oct2023 vid: 118 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 171583255 163879657 171583255 171583255 10.1111/add.16222 171583255 ppf: 1835 ppct: 16 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Estimating the true effectiveness of smoking cessation interventions under variable comparator conditions: A systematic review and meta‐regression. aug: au: Kraiss, Jannis Viechtbauer, Wolfgang Black, Nicola Johnston, Marie Hartmann‐Boyce, Jamie Eisma, Maarten Javornik, Neza Bricca, Alessio Michie, Susan West, Robert de Bruin, Marijn affil: Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands sug: subj: Smoking Cessation Prevention and Control Behavior Therapy Methods Cost Effectiveness Analysis Treatment Outcomes Human Systematic Review Meta Analysis Regression Prediction Models Confidence Intervals Counseling Methods ab: Background and aims: Behavioural smoking cessation trials have used comparators that vary considerably between trials. Although some previous meta‐analyses made attempts to account for variability in comparators, these relied on subsets of trials and incomplete data on comparators. This study aimed to estimate the relative effectiveness of (individual) smoking cessation interventions while accounting for variability in comparators using comprehensive data on experimental and comparator interventions. Methods: A systematic review and meta‐regression was conducted including 172 randomised controlled trials with at least 6 months follow‐up and biochemically verified smoking cessation. Authors were contacted to obtain unpublished information. This information was coded in terms of active content and attributes of the study population and methods. Meta‐regression was used to create a model predicting smoking cessation outcomes. This model was used to re‐estimate intervention effects, as if all interventions have been evaluated against the same comparators. Outcome measures included log odds of smoking cessation for the meta‐regression models and smoking cessation differences and ratios to compare relative effectiveness. Results: The meta‐regression model predicted smoking cessation rates well (pseudo R2 = 0.44). Standardising the comparator had substantial impact on conclusions regarding the (relative) effectiveness of trials and types of intervention. Compared with a 'no support comparator', self‐help was 1.33 times (95% CI = 1.16–1.49), brief physician advice 1.61 times (95% CI = 1.31–1.90), nurse individual counselling 1.76 times (95% CI = 1.62–1.90), psychologist individual counselling 2.04 times (95% CI = 1.95–2.15) and group psychologist interventions 2.06 times (95% CI = 1.92–2.20) more effective. Notably, more elaborate experimental interventions (e.g. psychologist counselling) were typically compared with more elaborate comparators, masking their effectiveness. Conclusions: Comparator variability and underreporting of comparators obscures the interpretation, comparison and generalisability of behavioural smoking cessation trials. Comparator variability should, therefore, be taken into account when interpreting and synthesising evidence from trials. Otherwise, policymakers, practitioners and researchers may draw incorrect conclusions about the (cost) effectiveness of smoking cessation interventions and their constituent components. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|