Does the Schedule of an Intervention Differ weather it is Used as Experimental or Control? The Experience of The Cochrane Drugs and Alcohol Group

Article type
Authors
Marica F, Laura A, Marina D, Simona V, Carlo A P
Abstract
Objectives: To investigate the differences in dosage and modality of administration of treatments used as experimental intervention or as control.

Methods: We analysed the studies included in the 5 reviews on opioid detoxification already published on the Cochrane Library. From the tables of included studies, we selected the different pharmacological treatments and collected the available information on doses offered. For every single treatment agent, we calculated the mean dose and the standard deviation both for the experimental group and the control group. The mean dosages where compared using the student t test.

Results: The studies included in the 5 reviews were 37, with a total of 2498 participants (range 20 - 200) and 43 comparisons. We identified 3 main different treatments related to detoxification with a total of 1570 subjects involved in the comparisons. Twenty-three trials included methadone, 11 as experimental treatment (subjects= 163), doses available for 8/11, mean dose 51.25mg, SD 45.2, 17 as control (subjects= 472), doses available for 15/17, mean 41.6mg, SD 31.0, p=0.55; 23 trials investigated clonidine, all the studies included had information on doses, 19 as experimental treatment (subjects=623), mean dose1.21mg, SD 0.78, 4 as control (subjects=103), mean 0.75mg, SD 0.5, p=0.27; 7 trials included lofexidine, all the studies included had information on doses, 4 as experimental treatment (subjects=144), mean dose 2.0mg, SD 0, 3 as control (subjects=65), mean 3.0mg, SD 1.7, p=0.28.

Conclusions: As far as detoxification treatments for opiate dependence are concerned, the doses administered were heterogeneous among the studies but there were no statistically significant differences weather the pharmacological agent was given as experimental treatment or as control intervention.. In this specific case the choice of some reviewers to switch control or treatment groups according to the review protocol seems feasible and acceptable.