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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0788

Reinterpreting treatment benefit in depression trials using stakeholder-weighted composite outcome measures

RE-INTERPRETING TREATMENT BENEFIT IN DEPRESSION TRIALS USING STAKEHOLDER-WEIGHTED COMPOSITE OUTCOMES

Cognitive behavioural therapy showed significant superiority in both depression trials when stakeholder-weighted composite outcome measures were used (CLASSIC d = -0.30, p = 0.005; COBALT d = -0.63, p < 0.001).

The study aimed to assess benefit in depression research not solely through symptom measures, but through composite outcome measures reflecting stakeholders’ priorities across multiple domains. Data from CLASSIC and COBALT, trials of cognitive behavioural therapy (CBT) for depression, were used. Within a multi-criteria decision modelling (MCDM) framework, composite measures were constructed using weights obtained from a previous point-allocation task, and these composites were analysed both individually and jointly in linear regression models. The importance of the domains was rated by 229 service users and clinicians, and experts by experience were involved throughout the study. The CLASSIC weights were 29% for depression, 27% for quality of life, 24% for anxiety, and 20% for self-esteem; the COBALT weights were 26% for depression, 25% for mental functioning, 21% for anxiety, 15% for panic, and 13% for physical functioning. CBT performed significantly better in both trials when composite measures were used: the effect size for CLASSIC was d = -0.30, p = 0.005, and for COBALT, d = -0.63, p < 0.001. Little heterogeneity between stakeholder groups was observed when group-specific composites were used. The authors note that eliciting stakeholder values after a trial (post hoc) to derive composite measures is feasible, that these measures complement rather than replace the primary outcome measure, and that the interpretation of CBT effectiveness remained unchanged. MCDM does not replace patient and public involvement during the trial, and weighting can only be applied to outcome measures included in the original trial.

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