Developing a multivariable prediction model to support personalized selection among five major empirically-supported treatments for adult depression. Study protocol of a systematic review and individual participant data network meta-analysis

PLoS ONE, vol. 20, pp. e0322124

Abstract

BACKGROUND: Various treatments are recommended as first-line options in practice guidelines for depression, but it is unclear which is most efficacious for a given person. Accurate individualized predictions of relative treatment effects are needed to optimize treatment recommendations for depression and reduce this disorder's vast personal and societal costs. AIMS: We describe the protocol for a systematic review and individual participant data (IPD) network meta-analysis (NMA) to inform personalized treatment selection among five major empirically-supported depression treatments. METHOD: We will use the METASPY database to identify randomized clinical trials that compare two or more of five treatments for adult depression: antidepressant medication, cognitive therapy, behavioral activation, interpersonal psychotherapy, and psychodynamic therapy. We will request IPD from identified studies. We will conduct an IPD-NMA and develop a multivariable prediction model that estimates individualized relative treatment effects from demographic, clinical, and psychological participant characteristics. Depressive symptom level at treatment completion will constitute the primary outcome. We will evaluate this model using a range of measures for discrimination and calibration, and examine its potential generalizability using internal-external cross-validation. CONCLUSIONS: We describe a state-of-the-art method to predict personalized treatment effects based on IPD from multiple trials. The resulting prediction model will need prospective evaluation in mental health care for its potential to inform shared decision-making. This study will result in a unique database of IPD from randomized clinical trials around the world covering five widely used depression treatments, available for future research.

Authors 15

1. Ellen Driessen corresponding

   Radboud University Nijmegen · Pro Persona

   Affiliation as printed

   Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands

   Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, Netherlands

2. Orestis Efthimiou

   University of Bern · University of Oxford

   Affiliation as printed

   Department of Psychiatry, University of Oxford, Oxford, United Kingdom

   Institute of Primary Health Care, University of Bern, Bern, Switzerland

   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

3. Frederik J. Wienicke

   Pro Persona

   Affiliation as printed

   Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, Netherlands

4. Jasmijn Breunese

   Pro Persona

   Affiliation as printed

   Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, Netherlands

5. Pim Cuijpers

   Babeș-Bolyai University · Amsterdam Public Health · Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands

   International Institute for Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania

6. Thomas P. A. Debray

   Utrecht University · University Medical Center Utrecht

   Affiliation as printed

   Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands

   Smart Data Analysis and Statistics Besloten Vennootschap, Utrecht, Netherlands

7. David J. Fisher

   MRC Clinical Trials Unit at UCL · University College London · Medical Research Council

   Affiliation as printed

   Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom

8. Marjolein Fokkema Aachen Department of Methods and Statistics Institute of Psychology, Leiden University

   Leiden University

   Affiliation as printed

   Department of Methods and Statistics, Institute of Psychology, Leiden University, Leiden, Netherlands

9. Toshi A. Furukawa

   Kyoto University

   Affiliation as printed

   Department of Health Promotion and Human Behavior, Department of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan

10. Steven D. Hollon

    Vanderbilt University

    Affiliation as printed

    Department of Psychology, Vanderbilt University, Nashville, United States of America

11. Anuj H. P. Mehta

    University of Massachusetts Amherst

    Affiliation as printed

    Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, United States of America

12. Richard D Riley

    University of Birmingham

    Affiliation as printed

    Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom

13. Madison R. Schmidt

    Northwestern University

    Affiliation as printed

    Department of Clinical Psychology, Northwestern University Chicago, Chicago, United States of America

14. Jos W. R. Twisk

    Amsterdam University Medical Centers

    Affiliation as printed

    Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Amsterdam, Netherlands

15. Zachary Daniel Cohen corresponding

    University of Arizona

    Affiliation as printed

    Department of Psychology, University of Arizona, Tucson, United States of America