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Study designs and methods

Evidence Production for Psychosocial Treatment of Substance Use Problems

Lost in Translation?

Published Online:May 15, 2020https://doi.org/10.1024/0939-5911/a000646

Abstract

Abstract.Aims: In the article at hand we intend to discuss to what extent hitherto efforts towards standardization and quality assurance have been able to achieve stability concerning the production of evidence, and whether an actual evidence-based practice for psychosocial interventions for alcohol and drug problems is anywhere truly in the making. Methods: To explain several methodological inadequacies we make use of a perspective commonly referred to as the actor-network theory (ANT). This is characterized by a strong interest in detailed analysis of how an innovation or an idea is transformed due to interaction with its situated and specific conditions. The empirical material is taken from four earlier studies of our own hands. Results: We have given examples of how an unsystematic handling of different control group designs can lead to serious misinterpretations of intervention effects. The same goes for researcher allegiance, the use of different types of criteria in order to rank different types of evidence, unmotivated restrictions on the inclusion of evidence in a given systematic review, or as in the case of several US clearinghouses, to use extremely weak criteria when discriminating between what is evidence-based and what is not. Conclusions: We suggest that all of these shortcomings are directly or indirectly related to translations, modifications or neglect to adhere to methodological rules intended to produce a reduction of biases and increase standardization


Evidenz-Herstellung für die psychosoziale Behandlung von substanzbedingten Problemen – Verloren in der Übersetzung?

Zusammenfassung.Zielsetzung: Der vorliegende Artikel diskutiert, inwieweit die bisherigen Bemühungen um Standardisierung und Qualitätssicherung Stabilität bei der Herstellung von Evidenz erreichen konnten und ob tatsächlich eine evidenzbasierte Praxis für psychosoziale Interventionen bei Alkohol- und Drogenproblemen im Entstehen begriffen ist. Methode: Zur Erklärung einiger methodischer Unzulänglichkeiten wird die actor-network-Theorie (ANT) herangezogen. Diese legt ihr Hauptaugenmerk auf eine detaillierte Analyse der Art und Weise, wie eine Idee oder Innovation durch die Interaktion mit deren situativen und spezifischen Gegebenheiten umgewandelt wird. Das empirische Material stammt aus vier eigenen früheren Studien der Autoren. Ergebnisse: An Beispielen wurde gezeigt, wie ein unsystematischer Umgang mit verschiedenen Kontrollgruppendesigns zu schwerwiegenden Fehlinterpretationen von Interventionseffekten führen kann. Das Gleiche gilt für die Schulenzugehörigkeit von Forschern, die Verwendung verschiedener Arten von Kriterien, um verschiedene Evidenzstufen zu erreichen, unmotivierte Einschränkungen bei der Aufnahme von Evidenz in einen systematischen Review oder, wie im Fall mehrerer US-Clearingstellen, die Verwendung extrem schwacher Kriterien bei der Unterscheidung was evidenzbasiert ist und was nicht. Schlussfolgerungen: Es kann vermutet werden, dass die genannten Mängel direkt oder indirekt mit Übersetzungen, Modifikationen oder der Missachtung von methodischen Regeln zusammenhängen, die Verzerrungen reduzieren und eine erhöhte Standardisierung bewirken sollten.

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