This study is registered with PROSPERO, number CRD42012002291. We estimated summary odds ratios (ORs) using pairwise and network meta-analysis with random effects. Primary outcomes were efficacy (response rate) and acceptability (treatment discontinuations due to any cause). We assessed the studies' risk of bias in accordance to the Cochrane Handbook for Systematic Reviews of Interventions, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. In network meta-analysis, we used group-level data. We extracted data following a predefined hierarchy. We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression or patients with a serious concomitant medical illness. We included placebo-controlled and head-to-head trials of 21 antidepressants used for the acute treatment of adults (≥18 years old and of both sexes) with major depressive disorder diagnosed according to standard operationalised criteria. We searched Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS database, MEDLINE, MEDLINE In-Process, PsycINFO, the websites of regulatory agencies, and international registers for published and unpublished, double-blind, randomised controlled trials from their inception to Jan 8, 2016. We did a systematic review and network meta-analysis.
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