Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol
Background Comorbid depression is prevalent in people with multiple sclerosis (MS). Depression is commonly untreated or undertreated, thus, there is a need for effective and safe interventions and current guidelines recommend psychological and pharmaceutical interventions for people with MS. However...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e055796.full |
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| author | Amalia Karahalios Allan G Kermode Yvonne C Learmonth Julia Lyons Stephanie Campese Alexandra Metse Claudia H Marck |
| author_facet | Amalia Karahalios Allan G Kermode Yvonne C Learmonth Julia Lyons Stephanie Campese Alexandra Metse Claudia H Marck |
| author_sort | Amalia Karahalios |
| collection | DOAJ |
| description | Background Comorbid depression is prevalent in people with multiple sclerosis (MS). Depression is commonly untreated or undertreated, thus, there is a need for effective and safe interventions and current guidelines recommend psychological and pharmaceutical interventions for people with MS. However, research suggests that other interventions, such as exercise, could also be effective. The comparative efficacy and safety of intervention modalities have not been quantified.We plan to conduct a systematic review and network meta-analysis to compare efficacy and safety of psychological, pharmaceutical, physical and magnetic stimulation interventions for depression in people with MS.Methods and analysis We will search EMBASE, Medline, Cochrane CENTRAL, APA PsycINFO, Web of Science, CINAHL and PEDro from inception to 31 December 2021. Search terms will stem from three concepts: MS, depression and randomised controlled trials. Included studies will be randomised controlled trials, where participants are people with MS randomised to receive one of the aforementioned intervention types, and depression or depressive symptoms is the primary outcome, only outcome or secondary outcome with an a priori power calculation. Screening, data extraction and risk of bias assessment (using the Risk of Bias 2 tool) will be conducted independently by two reviewers. If possible, we will synthesise the evidence by fitting a frequentist network meta-analysis model with multivariate random effects, or a pairwise random-effects meta-analysis model. For each model, efficacy will be measured using a standardised mean difference, and safety using an OR. We plan to provide summary measures including forest plots, a geometry of the network, surface under the cumulative ranking curve, and a league table, and perform subgroup analyses. Otherwise, a narrative review will be provided.Ethics and dissemination Ethics is not required for a systematic review and network meta-analysis. Results will be published in a peer reviewed journal.PROSPERO registration number CRD42020209803. |
| format | Article |
| id | doaj-art-5b914a0abd9c415c80084148326fd828 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-5b914a0abd9c415c80084148326fd8282025-01-24T20:00:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-055796Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocolAmalia Karahalios0Allan G Kermode1Yvonne C Learmonth2Julia Lyons3Stephanie Campese4Alexandra Metse5Claudia H Marck62 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Univerisity of Melbourne, Melbourne, VIC, Australia3The Perron Institute for Neurological and Translational Science, The University of Western Australia, QEII Medical Centre, Nedlands, WA, AustraliaDiscipline of Exercise Science, Health Futures Institute, Murdoch University, Murdoch, Western Australia, AustraliaDisability and Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, AustraliaDisability and Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, AustraliaSchool of Psychology, University of Newcastle, Callaghan, New South Wales, AustraliaDisability and Health Unit, Centre for Health Equity, the Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaBackground Comorbid depression is prevalent in people with multiple sclerosis (MS). Depression is commonly untreated or undertreated, thus, there is a need for effective and safe interventions and current guidelines recommend psychological and pharmaceutical interventions for people with MS. However, research suggests that other interventions, such as exercise, could also be effective. The comparative efficacy and safety of intervention modalities have not been quantified.We plan to conduct a systematic review and network meta-analysis to compare efficacy and safety of psychological, pharmaceutical, physical and magnetic stimulation interventions for depression in people with MS.Methods and analysis We will search EMBASE, Medline, Cochrane CENTRAL, APA PsycINFO, Web of Science, CINAHL and PEDro from inception to 31 December 2021. Search terms will stem from three concepts: MS, depression and randomised controlled trials. Included studies will be randomised controlled trials, where participants are people with MS randomised to receive one of the aforementioned intervention types, and depression or depressive symptoms is the primary outcome, only outcome or secondary outcome with an a priori power calculation. Screening, data extraction and risk of bias assessment (using the Risk of Bias 2 tool) will be conducted independently by two reviewers. If possible, we will synthesise the evidence by fitting a frequentist network meta-analysis model with multivariate random effects, or a pairwise random-effects meta-analysis model. For each model, efficacy will be measured using a standardised mean difference, and safety using an OR. We plan to provide summary measures including forest plots, a geometry of the network, surface under the cumulative ranking curve, and a league table, and perform subgroup analyses. Otherwise, a narrative review will be provided.Ethics and dissemination Ethics is not required for a systematic review and network meta-analysis. Results will be published in a peer reviewed journal.PROSPERO registration number CRD42020209803.https://bmjopen.bmj.com/content/12/6/e055796.full |
| spellingShingle | Amalia Karahalios Allan G Kermode Yvonne C Learmonth Julia Lyons Stephanie Campese Alexandra Metse Claudia H Marck Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol BMJ Open |
| title | Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol |
| title_full | Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol |
| title_fullStr | Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol |
| title_full_unstemmed | Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol |
| title_short | Comparing the effectiveness, safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis: a systematic review and network meta-analysis protocol |
| title_sort | comparing the effectiveness safety and tolerability of interventions for depressive symptoms in people with multiple sclerosis a systematic review and network meta analysis protocol |
| url | https://bmjopen.bmj.com/content/12/6/e055796.full |
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