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. 2021 Dec 15;2021(12):CD008012. doi: 10.1002/14651858.CD008012.pub4

McLaughlin 2005.

Study characteristics
Methods RCT design: 2‐arm parallel‐group trial
Total N randomised: 100
Length of follow‐up: 4 months
Analysis: per‐protocol (8 treatment participants dropped out, 12 control participants dropped out)
Participants Location: USA
Number of study centres and setting: patients with ACS from 2 hospitals
CAD diagnosis: ACS assessed by medical chart review in the coronary care unit; time to randomisation not specified
Depression diagnosis: score of 7 and more on either subscale of the HADS
Other entry criteria: 35 years of age or older, able to speak English, access to a touch‐tone phone
Exclusion criteria: mental health care in the prior 3 months, psychoactive drug use during the past year, and diagnosis of substance abuse during the past year
Treatment N: 45 (31.1% female, mean age: 59.9 (SD: 10.2))
Control N: 34 (35.3% female, mean age: 60.7 (SD: 9.8))
Comparability of the groups: significantly higher anger scores amongst females in the treatment group, significantly more participants with MI in the treatment group
Interventions Treatment: 6 telephone counselling sessions (30 minutes each) with clinicians (psychiatrist, clinical psychologist, internist) comprising review of common fears experienced by those living with chronic medical conditions and identification and management of barriers to adjustment to medical illness; participants with HADS score > 15 were referred for emergent care
Control: usual care (received a booklet on coping with cardiac illness typical of those given at hospital discharge and were instructed to contact their primary care physician if they experienced any warning signs of depression; advised to continue follow‐up with their primary care and specialist physicians)
Duration of treatment: 8 weeks
Outcomes Review outcomes: depression symptoms (HADS), all‐cause mortality
Other outcomes: anxiety symptoms (HADS), Work and Social Adjustment Scale (WSAS), State‐Trait Anger Expression Inventory (STAXI), clinical global impressions
Funding National Institute of Mental Health, USA; Robert Wood Johnson Foundation
Notes Mixed study sample (patients with depression and/or anxiety)
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "by coin flip" (p. 1085 in McLaughlin et al., 2005)
Allocation concealment (selection bias) High risk Quote: "The study coordinator conducted the coin flip and assigned patients to a treatment arm when she contacted study participants by telephone and enrolled consenting participants." (p. 540 in Bambauer et al., 2005)
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk Comment: No sufficient information provided
Blinding of outcome assessment (detection bias)
All outcomes High risk Comment: Primary outcome was patient self‐report measure (HADS); other blinding not stated
Incomplete outcome data (attrition bias)
All outcomes High risk Comment: The authors describe that multiple imputation methods were used to examine if data were missing at random. But all analyses were reported for the final cohort of 79 patients
Selective reporting (reporting bias) Unclear risk Comment: no protocol and design paper available
Comment: outcomes consistent in methods and results sections
Other bias Unclear risk Comment: weekly meetings and supervision of counsellors; monitoring quality not otherwise specified
Comment: depression data reported as β value unit change and final HADS depression scores post‐treatment