Reducing self-harm in adolescents: the RISA-IPD individual patient data meta-analysis and systematic review.

IF 3.5 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
David Cottrell, Alex Wright-Hughes, Amanda Farrin, Rebecca Walwyn, Faraz Mughal, Alex Truscott, Emma Diggins, Donna Irving, Peter Fonagy, Dennis Ougrin, Daniel Stahl, Judy Wright
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引用次数: 0

Abstract

Background: Self-harm is common in adolescents and a major public health concern. Evidence for effective interventions is lacking. An individual patient data meta-analysis has the potential to provide more reliable estimates of the effects of therapeutic interventions for self-harm than conventional meta-analyses, to explore which treatments are best suited to certain groups.

Method: A systematic review and individual patient data meta-analysis of randomised controlled trials of therapeutic interventions to reduce repeat self-harm in adolescents who had a history of self-harm and presented to clinical services. Primary outcome was repetition of self-harm. The methods employed for searches, study screening and selection, and risk of bias assessment are described, with an overview of the outputs of the searching, selection and quality assessment processes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance is followed.

Results: We identified a total 39 eligible studies, from 10 countries, where we sought Individual Patient Data (IPD), of which the full sample of participants were eligible in 18 studies and a partial sample of participants were eligible in 21 studies. We obtained IPD from 26 studies of 3448 eligible participants. For our primary outcome, repetition of self-harm, only 6 studies were rated as low risk of bias with 10 rated as high risk (although 2 of these were for secondary outcomes only).

Conclusions: Obtaining individual patient data for meta-analyses is possible but very time-consuming, despite clear guidance from funding bodies that researchers should share their data appropriately. More attention needs to be paid to seeking appropriate consent from study participants for (pseudo) anonymised data-sharing and institutions need to collaborate on agreeing template data-sharing agreements. Researchers and funders need to consider issues of research design more carefully. Our next step is to analyse all the data we have collected to see if it will tell us more about how we might prevent repetition of self-harm in young people.

Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 17/117/11. A plain language summary of this research article is available on the NIHR Journals Library Website https://doi.org/10.3310/GTNT6331.

减少青少年自我伤害:RISA-IPD个体患者数据荟萃分析和系统回顾。
背景:自残在青少年中很常见,也是一个主要的公共卫生问题。目前缺乏有效干预的证据。与传统的荟萃分析相比,个体患者数据荟萃分析有可能对自残治疗干预的效果提供更可靠的估计,从而探索哪些治疗方法最适合某些群体:方法:对减少有自残史并向临床服务机构求助的青少年重复自残的治疗干预随机对照试验进行系统回顾和个体患者数据荟萃分析。主要结果为重复自残。本文介绍了检索、研究筛选和选择以及偏倚风险评估所采用的方法,并概述了检索、选择和质量评估过程的结果。结果:我们在 10 个国家共发现了 39 项符合条件的研究,并在这些研究中寻求了患者个体数据(IPD),其中 18 项研究的全部参与者样本符合条件,21 项研究的部分参与者样本符合条件。我们从 26 项研究的 3448 名合格参与者中获得了 IPD。对于我们的主要结果--重复自残,只有 6 项研究被评为低偏倚风险,10 项被评为高风险(尽管其中 2 项仅针对次要结果):为荟萃分析获取患者个人数据是可能的,但非常耗时,尽管资助机构明确指导研究人员应适当共享数据。需要更加重视就(伪)匿名数据共享征求研究参与者的适当同意,各机构需要合作商定数据共享协议模板。研究人员和资助者需要更仔细地考虑研究设计问题。下一步,我们将对收集到的所有数据进行分析,看看这些数据是否能告诉我们更多关于如何防止青少年再次自我伤害的信息:本文介绍了由美国国家健康与护理研究所(NIHR)健康技术评估项目资助的独立研究,获奖编号为 17/117/11。该研究文章的简明摘要可在国家健康与护理研究所期刊图书馆网站 https://doi.org/10.3310/GTNT6331 上查阅。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health technology assessment
Health technology assessment 医学-卫生保健
CiteScore
6.90
自引率
0.00%
发文量
94
审稿时长
>12 weeks
期刊介绍: Health Technology Assessment (HTA) publishes research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS.
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