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How Many Meta-Analyses Does it Take to Settle a Question?

Linden, Wolfgang PhD

Psychosomatic Medicine:
doi: 10.1097/PSY.0b013e318295e046
Editorial Comment

Abstract: Psychological treatments (PTs) are used as adjuncts to cardiac care. This issue of Psychosomatic Medicine provides a meta-analysis by Rutledge et al. (3) on the effects of PT and cardiac rehabilitation on depression and cardiac outcomes, and the journal recently published a systematic review and meta-regression on a similar topic by Dickens et al. (4). This editorial compares the results from these two meta-analyses and discusses the problems associated with combining different types of PT and other treatments, dose-response effects, floor effects, collapsing across outcomes, and therapist qualifications. PTs have mixed but generally positive effects on reducing mortality and cardiac outcomes, but it remains a challenge explaining how such beneficial outcomes can be achieved by relatively small effects on well-being (typical effect sizes: d = 0.2–0.3). Randomized controlled trials are needed on timing of PT, patients with cardiac problems who will benefit most from PT, and the mechanisms by which PT improves cardiac outcomes.

Author Information

Department of Psychology University of British Columbia Vancouver, British Columbia Canada

Copyright © 2013 by American Psychosomatic Society

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