STAR*D: helping to close the gap between science and practice.
Practical clinical trials, such as STAR*D (Sequenced Treatment Alternatives to Relieve Depression), extend the traditional randomized controlled trial to real-world settings. Consumers and clinicians should be encouraged by STAR*D's 70% remission rate and should realize that for many participants remission required medication switching and augmentation. Policy makers should recognize the importance of easy access to a full range of treatments. Researchers should be sobered by the high attrition rate and the 30% of participants who did not achieve remission. Although more such practical trials are needed, future work must more meaningfully involve consumers in design, analysis, and interpretation.
Shern
David L
DL
Mental Health America, Alexandria, VA 22311, USA. dshern@mentalhealth america.net
Moran
Hazel
H
D002986:Clinical Trials as Topic; D003254:Consumer Advocacy; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000628:therapy; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D011320:Primary Health Care; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors