Adolescent self-harm is a pressing public health issue lacking sufficient evidence-based interventions. However, a recent study leverages an individual patient data (IPD) meta-analysis to provide more accurate estimates of therapeutic intervention effects, potentially unveiling the most appropriate treatments for specific adolescent groups. This approach could significantly influence market access by highlighting effective, targeted therapies.
Comprehensive Methodology
Researchers conducted a systematic review and IPD meta-analysis of randomized controlled trials focusing on therapeutic interventions aimed at reducing repeated self-harm in adolescents. The primary measure was the recurrence of self-harm incidents. The study adhered to rigorous procedures for search, study selection, and bias risk assessment, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This meticulous approach ensures the reliability of the findings and their potential impact on clinical practice and market access for new interventions.
Extensive Data Collection
The study identified 39 eligible trials from 10 countries. Out of these, 26 studies, encompassing 3448 eligible participants, provided IPD. The sample integrity varied, with 18 studies offering full participant data and 21 studies contributing partial data. Among the primary outcomes, only six studies were deemed low risk for bias, whereas ten were rated high risk. These insights underline the necessity for uniform data-sharing agreements and standardized consent procedures, which could streamline future research and improve market access for new therapeutic options.
The results emphasize the complexities and time-consuming nature of obtaining IPD for meta-analyses, despite clear guidelines from funding agencies. Researchers and institutions need to prioritize developing template data-sharing agreements and ensuring appropriate participant consent for anonymized data use. Such measures will enhance the robustness of future meta-analyses, ultimately benefiting market access efforts for effective self-harm interventions.
Valuable Inferences
Key inferences from the study include:
- Uniform data-sharing agreements facilitate broader, more effective research.
- Standardized consent processes are crucial for ethical data use.
- Identifying low-risk studies can guide future intervention strategies.
- Enhanced collaboration among institutions can expedite market access for new therapies.
The study’s next phase involves analyzing the collected data to determine more about preventing self-harm recurrence in adolescents. This work will likely inform clinical practices and enhance the development and market access of new, targeted therapeutic interventions.
Original Article:
Health Technol Assess. 2024 Jul 10:1-42. doi: 10.3310/GTNT6331. Online ahead of print.
ABSTRACT
BACKGROUND: Self-harm is common in adolescents and a major public health concern. Evidence for effective interventions is lacking. An individual patient data meta-analysis has the potential to provide more reliable estimates of the effects of therapeutic interventions for self-harm than conventional meta-analyses, to explore which treatments are best suited to certain groups.
METHOD: A systematic review and individual patient data meta-analysis of randomised controlled trials of therapeutic interventions to reduce repeat self-harm in adolescents who had a history of self-harm and presented to clinical services. Primary outcome was repetition of self-harm. The methods employed for searches, study screening and selection, and risk of bias assessment are described, with an overview of the outputs of the searching, selection and quality assessment processes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance is followed.
RESULTS: We identified a total 39 eligible studies, from 10 countries, where we sought Individual Patient Data (IPD), of which the full sample of participants were eligible in 18 studies and a partial sample of participants were eligible in 21 studies. We obtained IPD from 26 studies of 3448 eligible participants. For our primary outcome, repetition of self-harm, only 6 studies were rated as low risk of bias with 10 rated as high risk (although 2 of these were for secondary outcomes only).
CONCLUSIONS: Obtaining individual patient data for meta-analyses is possible but very time-consuming, despite clear guidance from funding bodies that researchers should share their data appropriately. More attention needs to be paid to seeking appropriate consent from study participants for (pseudo) anonymised data-sharing and institutions need to collaborate on agreeing template data-sharing agreements. Researchers and funders need to consider issues of research design more carefully. Our next step is to analyse all the data we have collected to see if it will tell us more about how we might prevent repetition of self-harm in young people.
FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 17/117/11. A plain language summary of this research article is available on the NIHR Journals Library Website https://doi.org/10.3310/GTNT6331.
PMID:39024118 | DOI:10.3310/GTNT6331
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