Efficacy of psychosocial interventions in cancer care: Evidence is weaker than it first looks
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
With increasing sophistication, successive reviews find weaker evidence for the efficacy of psychosocial interventions to reduce distress among cancer patients. However, these appraisals may still be overly positive because of reviewers’ uncritical acceptance of flaws in the design, analysis, and reporting of the results of such trials. Using randomized trials from high-impact journals, we show confirmatory bias, selective reporting of the most favorable of multiple outcome measures, suppressing of null results in subsequent citations of trials, and dropping of data for patients least likely to benefit from intervention. The conclusion that typical cancer patients do not benefit from interventions to reduce distress is strengthened when these endemic problems with the literature are taken into account. Required registering of the details of clinical trials and adherence to CONSORT reduces but does not eliminate bias in the literature.
- Altman DG: The scandal of poor medical research: We need less research, better research, and research done for the right reasons.British Medical Journal. 1994,308:283–284.
- Lepore SJ, Coyne JC: Psychological interventions and distress in cancer patients: A review of reviews.Annals of Behavioral Medicine. 2006,32:85–92. [this issue] CrossRef
- Edelman S, Craig A, Kidman AD: Group interventions with cancer patients: Efficacy of psychoeducational versus supportive groups.Journal of Psychosocial Oncology. 2000,18:67–85. CrossRef
- Butler LD, Koopman C, Cordova MJ, et al.: Psychological distress and pain significantly increase before death in metastatic breast cancer patients.Psychosomatic Medicine. 2003,65:416–426. CrossRef
- Classen C, Butler LD, Koopman C, et al.: Supportive-expressive group therapy and distress in patients with metastatic breast cancer—A randomized clinical intervention trial.Archives of General Psychiatry. 2001,58:494–501. CrossRef
- Antoni MH, Lehman JM, Kilbourn KM, et al.: Cognitivebehavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer.Health Psychology. 2001,20:20–32. CrossRef
- Zakowski SG, Ramati A, Morton C, et al.: Written emotional disclosure buffers the effects of social constraints on distress among cancer patients.Health Psychology. 2004,23:555–563. CrossRef
- Altman DG, Schulz KF, Moher D: The revised CONSORT statement for reporting randomized trials: Explanation and elaboration.Annals of Internal Medicine. 2001,134:663–694.
- Schulz KF, Chalmers I, Hayes RJ, Altman DG: Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials.Journal of the American Medical Association. 1995,273:408–412. CrossRef
- Begg C, Cho M, Eastwood S, et al.: Improving the quality of reporting of randomized controlled trials: The CONSORT statement.Journal of the American Medical Association. 1996,276:637–639. CrossRef
- Shapiro SH, Weijer C, Freedman B: Reporting the study populations of clinical trials: Clear transmission or static on the line?Journal of Clinical Epidemiology. 2000,53:973–979. CrossRef
- Manne SL, Ostroff JS, Winkel G, et al.: Couple-focused group intervention for women with early stage breast cancer.Journal of Consulting and Clinical Psychology. 2005,73:634–646. CrossRef
- Cook JM, Palmer SC, Coyne JC: Reporting of randomized clinical trials in journal of consulting and clinical psychology 1992 and 2002: Before CONSORT and beyond. Manuscript submitted for publication.
- Cohen J:Statistical Power Analysis for the Behavioral Sciences (2nd Ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1988.
- Spiegel D, Giese-Davis J: Depression and cancer: Mechanisms and disease progression.Biological Psychiatry. 2003,54:269–282. CrossRef
- Edwards AGK, Hailey S, Maxwell M: Psychological interventions for women with metastatic breast cancer (Cochrane Review).The Cochrane Library, Issue 3. Chichester, UK: Wiley, 2005.
- Antoni MH, Carver CS: More may not be better in psychosocial interventions for cancer patients—Reply to Coyne and Kagee.Health Psychology. 2001,20:458–459. CrossRef
- Giese-Davis J, Koopman, C, Butler LD, et al.: Change in emotion-regulation strategy for women with metastatic breast cancer following supportive-expressive group therapyJournal of Consulting and Clinical Psychology. 2002,70:916–925. CrossRef
- Penedo FJ, Dahn JR, Molton I, et al.: Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinoma.Cancer. 2004,100:192–200. CrossRef
- Laperriere A, Ironson, GH, Antoni, MH, et al.: Decreased depression up to one year following CBSM plus intervention in depressed women with AIDS: The smart/EST women’s projects.Journal of Health Psychology. 2005,10:223–231. CrossRef
- de Moor C, Sterner J, Hall M, et al.: A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma.Health Psychology. 2002,21:615–619. CrossRef
- Rosenberg HJ, Rosenberg SD, Ernstoff MS, et al.: Expressive disclosure and health outcomes in a prostate cancer population.International Journal of Psychiatry in Medicine. 2002,32:37–53. CrossRef
- Stanton AL, Danoff-Burg S, Sworowski LA, et al.: Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients.Journal of Clinical Oncology. 2002,20:4160–4168. CrossRef
- Walker BL, Nail LM, Croyle RT: Does emotional expression make a difference in reactions to breast cancer?Oncology Nursing Forum. 1999,26:1025–1032.
- Frisina PG, Borod J, Lepore SJ: A meta-analysis of the effects of written emotional disclosure on health outcomes of clinical populations.Journal of Nervous and Mental Disease. 2004,192:629–634. CrossRef
- Mills JL: Data torturing.New England Journal of Medicine. 1993,329:1196–1199. CrossRef
- Schulz KF, Grimes DA: Epidemiology 4—Multiplicity in randomised trials I: Endpoints and treatmentsLance. 2005,365:1591–1595. CrossRef
- Chan AW, Hrobjartsson A, Haahr, MT, Gotzsche PC, Altman DG: Empirical evidence for selective reporting of outcomes in randomized trials—Comparison of protocols to published articles.Journal of the American Medical Association. 2004,291:2457–2465. CrossRef
- Dickersin K, Rennie D: Registering clinical trialsJournal of the American Medical Association. 2003,290:516–523. CrossRef
- Pocock SJ: Clinical trials with multiple outcomes: A statistical perspective on their design, analysis, and interpretation.Controlled Clinical Trials. 1997,18:530–545. CrossRef
- Yusuf S, Wittes J, Probstfield J, Tyroler HA: Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical-trials.Journal of the American Medical Association. 1991,266:93–98. CrossRef
- Assmann SF, Pocock SJ, Enos LE, Kasten LE: Subgroup analysis and other (mis)uses of baseline data in clinical trials.Lancet. 2000,355:1064–1069. CrossRef
- Senn S, Harrell F: On wisdom after the event.Journal of Clinical Epidemiology. 1997,50:749–751. CrossRef
- Brooks ST, Whitely E, Egger M: Subgroup analyses in randomized trials: risks of subgroup-specific analyses; power and sample size for the interaction test.Journal of Clinical Epidemiology. 2004,57:229–236. CrossRef
- Lees-Haley P, Price JR, Williams CW, Betz BP: Use of the impact of events scale in the assessment of emotional distress and PTSD may produce misleading results.Journal of Forensic Neurospychology. 2001,2:45–52. CrossRef
- Goodwin PJ, Leszcz M, Ennis M, et al.: The effect of group psychosocial support on survival in metastatic breast cancer.New England Journal of Medicine. 2001,345:1719–1726. CrossRef
- McNair DM, Lorr M, Droppleman LF:EITS Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service, 1971.
- Lee YJ, Ellenberg JH, Hirtz DG, Nelson KB: Analysis of clinical trials by treatment actually received: Is it really an option?Statistics in Medicine. 1991,10:1595–1605. CrossRef
- Peduzzi P, Henderson W, Hartigan P, Lavori P: Analysis of randomized controlled trials.Epidemiologic Reviews. 2002,24:26–38. CrossRef
- Spiegel D, Bloom JR, Yalom I: Group support for patients with metastatic cancer.Archives of General Psychiatry. 1981,38:527–533.
- Ross L, Thomsen BL, Boesen EH, Johansen C: In a randomized controlled trial, missing data led to biased results regarding anxiety.Journal of Clinical Epidemiology. 2004,57:1131–1137. CrossRef
- Bordeleau L, Szalai JP, Ennis M, et al.: Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: Overall effects of the intervention and an exploration of missing data.Journal of Clinical Oncology. 2003,21:1944–1951. CrossRef
- Altman DG: Comparability of randomized groups.Statistician. 1985,34:125–136. CrossRef
- Sheard T, Maguire P: The effect of psychological interventions on anxiety and depression in cancer patients: Results of two meta-analyses.British Journal of Cancer. 1999,80:1770–1780. CrossRef
- Nezu AM, Nezu CM, Felgoise SH, McClure KS, Houts PS: Project Genesis: Assessing the efficacy of problem-solving therapy for distressed adult cancer patients.Journal of Consulting and Clinical Psychology. 2003,71:1036–1048. CrossRef
- Maunsell E, Brisson J, Deschenes L, Frasure-Smith N: Randomized trial of a psychologic distress screening program after breast cancer: Effects on quality of life.Journal of Clinical Oncology. 1996,14:2747–2755.
- Moynihan C, Bliss JM, Davidson J, Burchell L, Horwich A: Evaluation of adjuvant psychological therapy in patients with testicular cancer: Randomised controlled trial.British Medical Journal. 1998,316:429–435.
- Sollner W, Maislinger S, Konig A, Devries A, Lukas P: Providing psychosocial support for breast cancer patients based on screening for distress within a consultation-liaison service.Psycho- Oncology. 2004,13:893–897. CrossRef
- Gray RE, Fitch M, Davis C, Phillips C: Interviews with men with prostate cancer about their self-help group experience.Journal of Palliative Care. 1997,13:15–21.
- Moore KN, Estey A: The early post-operative concerns of men after radical prostatectomy.Journal of Advanced Nursing. 1999,29:1121–1129. CrossRef
- Shapiro PJ, Coyne JC, Kruus LK, Palmer SC: Interest in services among prostate cancer patients receiving androgen deprivation therapy.Psycho-Oncology. 2004,13:512–525. CrossRef
- Wong F, et al.: Men with prostate cancer: Influence of psychological factors on informational needs and decision making.Journal of Psychosomatic Research. 2000,49:13–19. CrossRef
- Efficacy of psychosocial interventions in cancer care: Evidence is weaker than it first looks
Annals of Behavioral Medicine
Volume 32, Issue 2 , pp 104-110
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors