title: STAR*D: helping to close the gap between science and practice.
abstract: 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.
authors.affiliation: Mental Health America, Alexandria, VA 22311, USA. dshern@mentalhealth america.net
authors.forename: David L
authors.initials: DL
authors.lastname: Shern
authors.forename: Hazel
authors.initials: H
authors.lastname: Moran
mesh_terms: 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
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors