Summary of findings 3. Contingency management + standard maintenance versus standard maintenance alone for antisocial personality disorder.
Contingency management + standard maintenance versus standard maintenance alone for antisocial personality disorder | ||||||
Patient or population: adults with antisocial personality disorder Setting: outpatient Intervention: contingency management + standard maintenance Comparison: standard maintenance alone | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Risk with standard maintenance alone | Risk with contingency management + standard maintenance | |||||
Aggression | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
Reconviction | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
Global state/functioning | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
Social functioning Assessed by: adjusted composite scores on the Family/Social domain of the Addiction Severity Index (composite scores range from no problems (0) to severe problems (1); higher score = worse outcome) Timing of assessment: 6 months |
The mean social functioning score in the control group was 0.16 points | The mean social functioning score in the intervention group was 0.08 points lower (0.14 lower to 0.02 lower) | ‐ | 83 (1 RCT) | ⊕⊕⊝⊝ Lowa | Analysis based on summary data of completers supplied by the trial investigators and derived from a mixed regression model that included time‐specific random effects and an interaction term (see Table 4). |
Adverse events | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: Randomised controlled trial. | ||||||
GRADE Working Group grades of evidence (Schünemann 2013) High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect |
aEvidence downgraded two levels overall. We downgraded one level due to possible risk of bias ('blinding of participants' bias, possible risk of 'blinding of personnel' and possible risk of 'incomplete outcome data/attrition' bias), and one level due to likely imprecision due to optimal information size criterion not met.