The randomized controlled clinical trial is still a relatively new technology for
assessing therapeutic interventions, yet innovations in the design and analysis of
clinical trials in psychiatry have lagged behind other areas of the biomedical sciences.
This delay in the advancement of the science and practice of psychiatric clinical
trials is due in part to the inability, dating back to the 1950s, to solve the problem
of the unreliability of psychiatric diagnosis and to the inability of psychiatric
researchers to develop common agreed-upon outcome measures. Even though advances have
been made in diagnosis and measurement, the existence of these and other methodological
problems continues to contribute to the limited success of acute-phase efficacy trials
in psychiatry. For example, in depression,
Thase 1999
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References
- Placing trials in context using Bayesian analysis. GUSTO revisited by Reverend Bayes.JAMA. 1995; 273: 871-875
- Toward evidence-based medical statistics. 1.Ann Intern Med. 1999; 130: 995-1004
- Toward evidence-based medical statistics. 2.Ann Intern Med. 1999; 130: 1005-1013
- On some applications of Bayesian methods in cancer clinical trials.Stat Med. 1992; 11: 37-53
- Methodological issues in maintenance therapy clinical trials.Arch Gen Psychiatry. 1991; 48: 313-318
- Robust Bayesian analysis of clinical trials.Stat Med. 1995; 14: 1379-1391
- An NIMH perspective on the use of placebos.Biol Psychiatry. 2000; 47: 689-691
- Flexible treatment strategies in chronic disease.Biol Psychiatry. 2000; 48: 605-614
Norquist G, Lebowitz B, Hyman S. Expanding the frontier of treatment research. Available at: http://journals.apa.org/prevention/volume2/pre0020001a.html. Accessed July 29, 2000.
- Methodological issues in developing new acute treatments for patients with bipolar illness.Biol Psychiatry. 2000; 48: 615-624
- Bayesian approaches to randomized trials.J R Stat Soc A. 1994; 157: 357-416
- How should efficacy be evaluated in randomized clinical trials of treatments for depression?.J Clin Psychiatry. 1999; 60: 23-31
U.S. Government Accounting Office (1994): Breast Conservation versus Mastectomy: Patient Survival in Day-to-Day Medical Practice and in Randomized Studies, PEMD-95-9. Washington, DC: U.S. Government Accounting Office.
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© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
