Critical appraisal:Walker J, Hansen CH, Martin P, Symeonides S, Gourley C, Wall L, et al 2014

Critical Appraisal

Article being appraised

Walker J, Hansen CH, Martin P, Symeonides S, Gourley C, Wall L, et al. Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicentre randomised controlled trial in patients with lung cancer. Lancet Oncol 2014 Sep;15(10):1168-76 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25175097.

Applicable clinical question

What is the role of psychological support and interventions in the treatment of lung cancer?

Key Facts

Study Design

randomised controlled trial

Study aims:

The study aimed to assess whether an integrated treatment programme for major depression was more effective than treatment as usual in treating depression in patients with lung cancer.

Number of Patients:

142

The average depression severity was assessed using the self-rated Symptom Checklist Depression Scale (SCL-20). Outcome data were collected every 4 weeks until 32 weeks post-randomisation.

Reported outcome(s):

Most (81%) of the participants who were allocated to the intervention group received at least four treatment sessions.

Results of outcome(s):

Average depression severity was significantly lower in patients in the intervention group than in those in the usual care group.

Self-rated depression, anxiety, quality of life, role functioning, perceived quality of care, and proportion of patients achieving a 12-week treatment response were also significantly better in the intervention group versus the usual care group.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias

Low risk of bias

Comments: Trial statisticians and staff who collected outcomes where masked, however participants and clinicians were not.

Show/Hide Risk of bias assessment

Risk of bias assessment: randomised controlled trial

Was the trial double-blinded?

No response

Was the treatment allocation schedule concealed?

No response

Were all randomised participants included in the analysis?

No response

The field below is not considered when calculating the risk of bias rating

How was the allocation schedule generated?

Adequate (e.g. random number table, computer random generator, coin tossing, card shuffling)

Size of effect

1	Reason for decision: depression severity was significantly lower in patients allocated to the intervention group. Anxiety quality of life were also significantly better in the intervention group compared to the treatment as usual group.

Relevance of evidence