Trials and tribulations in the meta-analysis of treatment differences: Comment

Author(s): Krause, M. S., Saunders, S. M., Kopta, S. M.

Journal/Book: Psychol Bull. 1997; 122: 750 First St NE, Washington, DC 20002-4242. Amer Psychological Assoc. 221-225.

Abstract: A fair test of the Dodo bird conjecture chat different psychotherapies are equally effective would entail separate comparisons of every pair of therapies. A meta-analysis of overall effect size for any particular set of such pairs is only relevant to the Dodo bird conjecture when the mean absolute value of differences is 0. The limitations of the underlying randomized clinical trials and the problem of uncontrolled causal variables make clinically useful treatment differences unlikely to be revealed by such heterogeneous meta-analyses. To enhance implications for practice, the authors recommend an intensified focus on patient-treatment interactions, cost-effectiveness variables, and separate meta-analyses for each pair of treatments.

Note: Editorial Howard KI, Northwestern Univ, Dept Psychol, 2029 Sheridan Blvd, Evanston,IL 60208 USA

Keyword(s): PSYCHOTHERAPY; METAANALYSIS; THERAPY

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