Triple P-Positive Parenting programs: the folly of basing social policy on underpowered flawed studies

BMC Medicine

Linda Kwakkenbos²  James C Coyne¹ 

[1] University of Groningen, Groningen, The Netherlands;Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada

关键词: confirmatory bias;    dissemination;    conflict of interest;    publication bias;    meta-analysis;   

Others  :  857227
DOI  :  10.1186/1741-7015-11-11

 received in 2012-12-21, accepted in 2013-01-16,  发布年份 2013

【 摘 要 】

Wilson et al. provided a valuable systematic and meta-analytic review of the Triple P-Positive Parenting program in which they identified substantial problems in the quality of available evidence. Their review largely escaped unscathed after Sanders et al.'s critical commentary. However, both of these sources overlook the most serious problem with the Triple P literature, namely, the over-reliance on positive but substantially underpowered trials. Such trials are particularly susceptible to risks of bias and investigator manipulation of apparent results. We offer a justification for the criterion of no fewer than 35 participants in either the intervention or control group. Applying this criterion, 19 of the 23 trials identified by Wilson et al. were eliminated. A number of these trials were so small that it would be statistically improbable that they would detect an effect even if it were present. We argued that clinicians and policymakers implementing Triple P programs incorporate evaluations to ensure that goals are being met and resources are not being squandered.

Please see related articles http://www.biomedcentral.com/1741-7015/10/130 webcite and http://www.biomedcentral.com/1741-7015/10/145 webcite

【 授权许可】

   
2013 Coyne and Kwakkenbos; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Wilson P, Rush R, Hussey S, Puckering C, Sim F, Allely CS, Doku P, McConnachie A, Gillberg C: How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P. BMC Med 2012, 10:130. BioMed Central Full Text
• [2]Sanders MR, Pickering JA, Kirby JN, Turner KMT, Morawska A, Mazzucchelli T, Ralph A, Sofronoff K: A commentary on evidence-based parenting programs: redressing misconceptions of the empirical support for Triple P. BMC Med 2012, 10:145. BioMed Central Full Text
• [3]Triple P: Positive Parenting Program [http://www.triplep.net/] webcite
• [4]Triple P for Practitioners [http://www19.triplep.net/?pid=59] webcite
• [5]Coyne JC, Thombs BD, Hagedoorn M: Ain't necessarily so: review and critique of recent meta-analyses of behavioral medicine interventions in health psychology. Health Psychol 2010, 29:107-116.
• [6]Kraemer HC, Gardner C, Brooks JO III, Yesavage JA: Advantages of excluding underpowered studies in meta-analysis: inclusionist versus exclusionist viewpoints. Psychol Methods 1998, 3:23-31.
• [7]Connell S, Sanders MR, Markie-Dadds C: Self-directed behavioral family intervention for parents of oppositional children in rural and remote areas. Behav Modif 1997, 21:379-408.
• [8]Turner KM, Sanders MR: Help when it's needed first: a controlled evaluation of brief, preventive behavioral family intervention in a primary care setting. Behav Ther 2006, 37:131-142.
• [9]Sterne JA, Gavaghan D, Egger M: Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol 2000, 53:1119-1129.
• [10]Hahlweg K, Heinrichs N, Kuschel A, Bertram H, Naumann S: Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort? Child Adolesc Psychiatry Ment Health 2010, 4:14. BioMed Central Full Text
• [11]Bodenmann G, Cina A, Ledermann T, Sanders MR: The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: a comparison with two other treatment conditions. Behav Res Ther 2008, 46:411-427.
• [12]Morawska A, Sanders MR: Self-administered behavioral family intervention for parents of toddlers: part I. Efficacy. J Consult Clin Psychol 2006, 74:10-19.
• [13]Sanders MR, Markie-Dadds C, Tully LA, Bor W: The Triple P-Positive Parenting Program: a comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. J Consult Clin Psychol 2000, 68:624-640.
• [14]Bettis RA: The search for asterisks: compromised statistical tests and flawed theories. Strat Mgmt J 2012, 33:108-113.
• [15]Giner-Sorolla R: Science or art? How aesthetic standards grease the way through the publication bottleneck but undermine science. Perspect Psychol Sci 2012, 7:562-571.
• [16]Simmons JP, Nelson LD, Simonsohn U: False-positive psychology: undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychol Sci 2011, 22:1359-1366.
• [17]Ioannidis J: Scientific inbreeding and same-team replication: Type D personality as an example. J Psychosom Res 2012, 73:408-410.