There are a number of ways to show that a given treatment is effective in treating a disease or clinical condition. Studies of treatments typically start either with laboratory studies establishing a possible or plausible effect of a treatment or with uncontrolled clinical observations of that effect.
How do we evaluate the efficacy of treatments?
Methods for evaluating efficacy often begin with health care professionals' judgments and then progress through more highly systematized research strategies. For some treatments, the most accessible source of information on treatment efficacy may be the judgment of health care professionals and patients who have experience with the treatments.
Is it possible to measure the effectiveness of therapy?
However, having outcome research that demonstrates the general effectiveness of therapy is only a start. It does not let you know whether therapy will help you specifically. This is where measuring therapy progress and outcomes while you are engaged in therapy can be helpful.
What determines treatment success?
Such factors, which are common to most treatment situations, can be powerful determinants of treatment success. Good guidelines allow for flexibility in treatment selection so as to maximize the range of choices among effective treatment alternatives.
What is the treatment strategy most likely to succeed?
The treatment strategy most likely to succeed usually combines the most effective specific interventions with a strong therapeutic relationship and a mutual expectation of and framework for improvement. Such factors, which are common to most treatment situations, can be powerful determinants of treatment success.
How is treatment effectiveness measured?
There are three main ways in which treatment effectiveness is measured: the patient's own impression of wellness, the therapist's impression, and some controlled research studies.
What are the shortcomings of a therapist's evaluation?
Shortcomings of Therapist's Evaluations. Therapists' evaluations of patients are subject to all of the same problems as patients' evaluations. They, too, may mistake regression to the mean for positive effects of treatment.
Why is it important to have a patient's impressions?
Obviously if a patient feels better, that's great. So in one sense, a patient's impressions are extremely important--the goal of therapy is, after all, to restore her to mental and emotional well-being. But for the purposes of determining which treatments are most effective in which situations, there are several problems with a patient's own impressions of her progress. The first is simply that people in distress tend to get better. This is known as regression to the mean, or average, and it's when people have a tendency to move toward an average level of functioning or happiness from whatever state they are in. If you're really happy, you're most likely to get sadder, and if you're really sad, you're most likely to get happier. People spend most of their time feeling average, so moods that are above or below average are likely to return to this average. Since people usually enter treatment because they're feeling especially bad, they're likely to get better over time not because of anything the therapist is doing, but simply because they're regressing to the mean.
Why do people with schizophrenia have lower recovery rates?
Patients least likely to get better tend to think negatively and behave hostilely. For reasons therapists don't thoroughly understand , personality disorders and psychotic disorders, like schizophrenia, tend to have lower rates of recovery in general.
Why is cognitive therapy effective?
These kinds of studies have shown that for depression and panic disorders, cognitive therapy is most effective, potentially because these disorders are in part caused by the kind of negative thinking directly addressed by cognitive therapy.
Why is empathy important in therapy?
Importance of Empathy In The Treatment Process. Regardless of the strategy they use, therapists who are warm and empathetic tend to have the highest rates of success with their patients. On the other hand, therapists who behave inappropriately can hinder therapeutic progress, or even do more harm than good.
Is stigma associated with therapy?
Stigma's Associated With Psychological Treatment. Therapy can only be effective if patients participate; many feel that there is a stigma associated with people who see therapists, or that therapy is just too expensive. In general, women are more likely to seek help than men.
Why are trials stopped early?
At times, trials are stopped early and reported because of positive, large treatment effects . However, early termination may introduce bias secondary to chance deviations from the “true effect” of treatment which would decrease if the trial was continued to completion.[15] .
What should urologists consider when making treatment decisions?
Finally, urologists should consider all patient-important outcomes as well as the balance of potential benefits, harms, and costs, and patient values and preferences when making treatment decisions. Conclusion:
Why is prognostic balance less certain?
At study's completion, the question of prognostic balance is less certain because of a relatively high rate of loss to follow-up.
Why is follow up important at the end of a trial?
In order to assure that both experimental and control groups are balanced at the end of a trial, complete follow-up information on each patient enrolled is important. Unfortunately, this is rarely the case at the close of a trial. Therefore, it is important to understand to what extent follow-up was incomplete.
Do RCTs have meta-analysis?
Ideally, a systematic review and meta-analysis of several randomized controlled trials (RCTs) will exist to guide treatment decisions. However, RCTs comprise a very small proportion of the urologic literature,[3] which inhibits meta-analysis.
Should urology trials be terminated early?
For this reason, critical readers of the urology literature should interpret trials terminated early with caution. In the case of the REDUCE trial, it appears that the trial went to completion, so this is not a concern in terms of the validity of the trial.
Why measure outcomes in therapy?
Why measure therapy outcomes? There are a variety of answers to this question, but if you are a person seeking therapy or counseling the answer is "so you and your therapist know if the therapy is helping". Tracking progress or outcomes in therapy helps you determine whether to continue spending your time, effort, ...
What is proof of effectiveness?
The proof of effectiveness is in the measured outcomes, e.g., student test scores, lowered blood pressure, or in the case of therapy, concrete measures of progress, effectiveness, and outcome. 1.
What is the purpose of measuring progress in therapy?
Measuring progress or effectiveness during the course of therapy allows a client and therapist to discuss what seems to be working, what doesn't seem to be working, and any need for adjustments to the treatment ( e.g., different approach, different focus, different therapist, or even an intervention other than therapy) if it is not helping.
Why is tracking progress important in therapy?
Tracking progress or outcomes in therapy helps you determine whether to continue spending your time, effort, and money on the process or to try something or someone different. For decades the measurement of therapy outcomes has primarily been the focus of researchers, not therapists. These researchers have typically focused on identifying which ...
Is research evidence that therapy in general is effective?
Consequently, the research evidence that therapy in general is effective is good to know if you are considering therapy. - If there was no evidence that the activity helps, why bother? However, having outcome research that demonstrates the general effectiveness of therapy is only a start.
Do you have to understand the process of blood pressure medication?
You do not have to fully understand the process of therapy to determine if it is helping, any more than you have to understand the process of how a blood pressure medication works to determine if it is working for you. You simply find an appropriate way to measure the effectiveness of the treatment.
Is tracking progress a standard practice?
In recent years tracking progress for individuals in therapy has started to become more commonplace, but it is by no means a standard practice. Therapy has often been considered a mysterious, emotional, intuitive, and powerful process that is difficult to quantify. These conceptions of therapy can all be true, but they do not ...
When deciding which treatments are of benefit, results from placebo-controlled trials are conventionally preferred above all others, and
When deciding which treatments are of benefit, results from placebo-controlled trials are conventionally preferred above all others, and treatments not supported by such trials are viewed sceptically. In this paper it is argued that while randomised controlled trials are desirable they are not always informative. Other, less robust, research designs can be acceptable when they provide independent evidence that their results are not invalidated by remission, regression to the mean, or placebo effect, particularly if they provide post-treatment follow-up assessments. Even when there are difficulties with a research design one can reasonably conclude that the treatment was responsible for the improvement provided a standard treatment was delivered, patient compliance was good, and a dose-response relationship was identified.
When is a research design acceptable?
Other, less robust, research designs can be acceptable when they provide independent evidence that their results are not invalidated by remission, regression to the mean, or placebo effect, particularly if they provide post-treatment follow-up assessments.
What is a treatment with proven effectiveness in one type of setting?
A treatment with proven effectiveness in one type of setting (e.g., the home, the school, day treatment, the clinic, the office, or the institution) may vary in effectiveness when it is offered in other settings. Good guidelines specify the settings in which the treatment has been documented to be effective.
Why are guidelines important for treatment?
Good guidelines allow for flexibility in treatment selection so as to maximize the range of choices among effective treatment alternatives.
Why are guideline panels recommended?
It is recommended that guideline panels make detailed recommendations to facilitate independent evaluation of the reliability of the guidelines they produce. Ascertaining whether the guidelines are interpreted and applied consistently by health care professionals comprises one assessment of reliability.
What is a criterion 7.2?
Criterion 7.2 It is recommended that guidelines take into account the effects on treatment outcome of interactions between the patient's and the health care professional's characteristics , including but not limited to language, ethnicity, background, sex, and gender.
What is the purpose of failure to disclose scientific justification for a guideline?
Moreover, failure to disclose the scientific justification for a guideline violates a basic principle of science, which requires open scrutiny and debate. Without the disclosure of adequate scientific information, guidelines are mere expressions of opinion.
Why are guidelines promulgated?
Guidelines are promulgated to encourage high quality care. Ideally, they are not promulgated as a means of establishing the identity of a particular professional group or specialty, nor are they used to exclude certain persons from practicing in a particular area.
What factors affect outcome?
Such factors as the professional's skill, experience, gender, language, and ethnic background can affect outcome in ways that are only partly understood. Criterion 7.1 It is recommended that guidelines take into account the effect of the health care professional's training, skill, and experience on treatment outcome.