Annals of Behavioral Medicine

, Volume 26, Issue 3, pp 161–171 | Cite as

Evidence-based behavioral medicine: What is it and how do we achieve it?

  • Karina W. Davidson
  • Michael Goldstein
  • Robert M. Kaplan
  • Peter G. Kaufmann
  • Genell L. Knatterud
  • C. Tracy Orleans
  • Bonnie Spring
  • Kimberlee J. Trudeau
  • Evelyn P. Whitlock

Abstract

The goal of evidence-based medicine is ultimately to improve patient outcomes and quality of care. Systematic reviews of the available published evidence are required to identify interventions that lead to improvements in behavior, health, and well-being. Authoritative literature reviews depend on the quality of published research and research reports. The Consolidated Standards for Reporting Trials (CONSORT) Statement (www.consort-statement.org) was developed to improve the design and reporting of interventions involving randomized clinical trials (RCTs) in medical journals. We describe the 22 CONSORT guidelines and explain their application to behavioral medicine research and to evidence-based practice. Additional behavioral medicine-specific guidelines (e.g., treatment adherence) are also presented. Use of these guidelines by clinicians, educators, policymakers, and researchers who design, report, and evaluate or review RCTs will strengthen the research itself and accelerate efforts to apply behavioral medicine research to improve the processes and outcomes of behavioral medicine practice.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. (1).
    Moher D, Schulz KF, Altman DG, for the CONSORT Group: The CONSORT Statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials.Journal of the American Medical Association. 2001,285:1987–1991.PubMedCrossRefGoogle Scholar
  2. (2).
    Eddy DM: Evidence-based clinical improvements.Presentation at Directions for Success: Evidence-Based Health Care Symposium sponsored by Group Health Cooperative, Tucson, AZ,2001.Google Scholar
  3. (3).
    Sox {jrJr.} HC, Woolf SH: Evidence-Based Practice Guidelines from the U.S. Preventive Services Task Force.Journal of the American Medical Association. 1993,169(20):2678.CrossRefGoogle Scholar
  4. (4).
    Woolf SH, Atkins DA: The evolving role of prevention in health care: Contributions of the U.S. Preventive Service Task Force.American Journal of Preventive Medicine. 2001,29(Supp. 3):13–20.CrossRefGoogle Scholar
  5. (5).
    Cook DJ, Greengold NL, Ellrodt G, Weingarten SR: The relation between systematic reviews and practice guidelines.Annals of Internal Medicine. 1997,127:210–216.PubMedGoogle Scholar
  6. (6).
    Cook DJ, Mulrow CD, Haynes RB: Systematic reviews: Synthesis of best evidence for clinical decisions.Annals of Internal Medicine. 1997,126(5):376–380.PubMedGoogle Scholar
  7. (7).
    Meade TW, Wald N, Collins R: CONSORT Statement on the reporting standards of clinical trials.BMJ. 1997,314:1126.PubMedGoogle Scholar
  8. (8).
    Altman DG, Schulz KF, Moher D, et al.: The revised CONSORT Statement for reporting randomized trials: Explanation and elaboration.Annals of Internal Medicine. 2001,134:663–694.PubMedGoogle Scholar
  9. (9).
    Rennie D: CONSORT revised: Improving the reporting of randomized trials.Journal of the American Medical Association. 2001,285(15):2006–2007.PubMedCrossRefGoogle Scholar
  10. (10).
    Whitlock EP, Orleans CT, Pender N, Allan J: Evaluating primary care behavioral counseling interventions: An evidence-based approach.American Journal of Preventive Medicine. 2002,22(4):267–284.PubMedCrossRefGoogle Scholar
  11. (11).
    Pigone MP, Ammerman A, Fernandez L, et al.: Counseling to promote a healthy diet in adults: A summary of the U.S. Preventive Services Task Force.American Journal of Preventive Medicine. 2003,24(1):75–92.CrossRefGoogle Scholar
  12. (12).
    U.S. Preventive Services Task Force: Behavioral counseling in primary care to promote physical activity: Recommendation and rationale.Annals of Internal Medicine. 2002,137:205–207.Google Scholar
  13. (13).
    Diabetes Prevention Program Research Group: The Diabetes Prevention Program: Design and methods for clinical trial in the prevention of Type 2 diabetes.Diabetes Care. 1999,22:623–634.CrossRefGoogle Scholar
  14. (14).
    Institute of Medicine (U.S.) Committee on Health and Behavior: Research Practice and Policy:Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington, DC: National Academy Press, 2001.Google Scholar
  15. (15).
    Kaplan RM: The Ziggy theorem: Toward an outcomes-focused health psychology.Health Psychology. 1994,13(6):451–460.PubMedCrossRefGoogle Scholar
  16. (16).
    Kaplan RM: Two pathways to prevention.American Psychologist. 2000,55(4):382–396.PubMedCrossRefGoogle Scholar
  17. (17).
    Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB: Recommendations of the Panel on Cost-Effectiveness in Health and Medicine.Journal of the American Medical Association. 1996,276(15):1253–1258.PubMedCrossRefGoogle Scholar
  18. (18).
    Harris RP, Helfand M, Woolf SH: Current methods of the U.S. Preventive Services Task Force.American Journal of Preventive Medicine. 2001,29(Supp. 3):21–35.CrossRefGoogle Scholar
  19. (19).
    Peto R, Pike MC, Armitage P, et al.: Design and analysis of randomized clinical trials requiring prolonged observation of each patient: I. Introduction and design.British Journal of Cancer. 1976,34(6):585–612.PubMedGoogle Scholar
  20. (20).
    Friedman LM, Furberg CD, DeMets DL:Fundamentals of Clinical Trials (3rd Ed.). New York: John Wright PSG Inc., 1998.Google Scholar
  21. (21).
    Pocock S:Clinical Trials: A Practical Approach. London: Wiley, 1983.Google Scholar
  22. (22).
    Coronary Drug Project Research Group: Practical aspects of decision making in clinical trials: The Coronary Drug Project as a case study.Controlled Clinical Trials. 1981,1(4):363–376.CrossRefGoogle Scholar
  23. (23).
    Peto R, Collins R, Gray R: Large-scale randomized evidence: Large, simple trials and overviews of trials.Journal of Clinical Epidemiology. 1995,48(1):23–40.PubMedCrossRefGoogle Scholar
  24. (24).
    Yusuf S, Collins R, Peto R, et al.: Intravenous and intracoronary fibrinolytic therapy in acute infarction: Overview of results on mortality, reinfarction and side-effects from 33 randomized controlled trials.European Heart Journal. 1985,6(7):556–585.PubMedGoogle Scholar
  25. (25).
    Meinert CL:Clinical Trials: Design, Conduct and Analysis. New York: Oxford University Press, 1983.Google Scholar
  26. (26).
    Kunz R, Oxman AD: The unpredictability paradox: Review of empirical comparisons of randomized and non-randomized clinical trials.BMJ. 1998,317(7167):1185–1190.PubMedGoogle Scholar
  27. (27).
    Clarke M, Oxman AD (eds):Cochrane Reviewers Handbook 4.2.0 [updated March 2003]. In The Cochrane Library, Issue 2, 2003. Oxford: Update Software.Google Scholar
  28. (28).
    Glassman AH, O’Connor CM, Califf RM, et al.: Sertraline treatment of major depression in patients with acute MI or unstable angina.Journal of the American Medical Association. 2002,288(6):701–709.PubMedCrossRefGoogle Scholar
  29. (29).
    Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD): Study design and methods. The ENRICHD investigators.American Heart Journal. 2000,139(1, Pt 1):1–9.Google Scholar
  30. (30).
    Glasgow RE, Whitlock EP, Eakin EG, Lichtenstein E: A brief smoking cessation intervention for women in low-income Planned Parenthood clinics.American Journal of Public Health. 2000,90(5):786–789.PubMedCrossRefGoogle Scholar
  31. (31).
    Green SB, Corle DK, Gail MH, et al.: Interplay between design and analysis for behavioral intervention trials with community as the unit of randomization.American Journal of Epidemiology. 1995,142(6):587–593.PubMedGoogle Scholar
  32. (32).
    Hollis S, Campbell F: What is meant by intention to treat analysis? Survey of published randomized controlled trials.BMJ. 1999,319:670–674.PubMedGoogle Scholar
  33. (33).
    Greenhalgh T: Assessing the methodological quality of published papers.BMJ. 1997,315:305–308.PubMedGoogle Scholar
  34. (34).
    Robinson LA, Berman JS, Neimeyer RA: Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research.Psychological Bulletin. 1990,108(1):30–49.PubMedCrossRefGoogle Scholar
  35. (35).
    Smith ML, Glass GV, Miller TI:The Benefits of Psychotherapy. Baltimore, MD: The Johns Hopkins University Press, 1980.Google Scholar
  36. (36).
    Gaffan EA, Tsaousis I, Kemp-Wheeler SM: Research allegiance and meta-analysis: The case of cognitive therapy for depression.Journal of Consulting and Clinical Psychology. 1995,63(6):966–980.PubMedCrossRefGoogle Scholar
  37. (37).
    Moncher FJ, Prinz RJ: Treatment fidelity in outcome studies.Clinical Psychology Review. 1991,11:247–266.CrossRefGoogle Scholar
  38. (38).
    Lichstein KL, Riedel BW, Grieve R: Fair tests of clinical trials: A treatment implementation model.Advanced Behavioral Research Therapy. 1994,16:1–29.CrossRefGoogle Scholar
  39. (39).
    McGrath PJ, Stinson J, Davidson K: Commentary: The Journal of Pediatric Psychology should adopt the CONSORT Statement as a way of improving the evidence base in pediatric psychology.Journal of Pediatric Psychology. 2003,28(3):169–171.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2003

Authors and Affiliations

  • Karina W. Davidson
    • 1
  • Michael Goldstein
    • 2
  • Robert M. Kaplan
    • 3
  • Peter G. Kaufmann
    • 4
  • Genell L. Knatterud
    • 5
  • C. Tracy Orleans
    • 6
  • Bonnie Spring
    • 7
  • Kimberlee J. Trudeau
    • 8
  • Evelyn P. Whitlock
    • 9
  1. 1.Mt. Sinai School of MedicineUSA
  2. 2.Bayer Institute for Health Care CommunicationUSA
  3. 3.University of CaliforniaSan DiegoUSA
  4. 4.National Heart, Lung, Blood InstituteUSA
  5. 5.Maryland Medical Research InstituteUSA
  6. 6.The Robert Wood Johnson FoundationUSA
  7. 7.University of Illinois at ChicagoUSA
  8. 8.City University of New York Graduate CenterUSA
  9. 9.Kaiser Permanente Center for Health ResearchUSA
  10. 10.Behavioral Cardiovascular Health & Hypertension Program, Columbia UniversityCollege of Physicians & SurgeonsNew York

Personalised recommendations