title: The MacArthur Competence Assessment Tools for assessing decision-making capacity in schizophrenia: A meta-analysis.
abstract: This meta-analysis aimed to examine the decisional capacity measured by the MacArthur Competence Assessment Tools (MacCAT) in schizophrenia.
  
  
  
  English (PubMed, PsycINFO, Embase, Cochrane Library databases and the Cochrane Controlled Trials Register) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from 1995 until August 1, 2016. Weighted and standardized mean differences were calculated. The random effects model was used in all cases.
  
  
  
  Altogether 10 studies were identified, with 7 studies using the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and 3 studies using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). The meta-analysis showed that there was significant impairment in decision-making capacity in schizophrenia patients compared to the healthy control group in terms of Understanding (SMD=-0.81, 95% CI: -1.06 to -0.56, P<0.001), Reasoning (SMD=-0.57, 95% CI: -0.80 to -0.34, P<0.001), Appreciation (SMD=-0.87, 95% CI: -1.20 to -0.53, P<0.001), and Expression a choice (SMD=-0.24, 95% CI: -0.43 to -0.05, P=0.01).
  
  
  
  Compared to the control group, schizophrenia patients are more likely to have impaired decision-making capacity in clinical research and treatment as measured by the MacCAT instruments. Researchers and clinicians need to consider the impaired decisional capacity in schizophrenia patients providing informed consent.
authors.affiliation: Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors.forename: Shi-Bin
authors.initials: SB
authors.lastname: Wang
authors.affiliation: Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Wang
authors.affiliation: University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Chee H
authors.initials: CH
authors.lastname: Ng
authors.affiliation: Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China.
authors.forename: Ren-Rong
authors.initials: RR
authors.lastname: Wu
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jijun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
mesh_terms: D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D003657:Decision Making / Q000502:physiology*; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology
keywords: MacArthur Competence Assessment Tools; Meta-analysis; Schizophrenia