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Enregistrement W90690077 · doi:10.1136/bmj.322.7284.493

Comparison of St John's wort and imipramine

2001· letter· en· W90690077 sur OpenAlexaff
Peter L. Cornwall

Notice bibliographique

RevueBMJ · 2001
Typeletter
Langueen
DomaineAgricultural and Biological Sciences
ThématiqueNatural Compound Pharmacology Studies
Établissements canadiensSunnybrook HospitalUniversity of Toronto
Organismes subventionnairesnon disponible
Mots-clésDepression (economics)ImipramineMedicinePlaceboAdverse effectInternal medicineComplete remissionPsychiatryAtypical depressionRandomized controlled trialClinical trialMoodAlternative medicineChemotherapy

Résumé

récupéré en direct d'OpenAlex

# Remission is important outcome {#article-title-2} EDITOR—The authors of either of the two large trials of St John's wort for treating depression published in the BMJ have reported the proportion of patients entering full remission of symptoms after acute treatment. 1 2 This is unfortunate as remission of symptoms rather than response to treatment should be the key outcome objective. Partial remission is a common adverse outcome of depression after short term treatment and carries with it a high risk of relapse and continuing disability.3 There is now emerging evidence that although all antidepressants seem to be similarly efficacious in producing a short term response, there are differences in remission rates, particularly in severely ill patients.4 This shows the importance of reporting categorical as well as continuous outcomes in clinical trials of treatment with antidepressants. 1. 1.↵1. Woelk H, for the Remotiv/Imipramine Study Group .Comparison of St John's wort and imipramine for treating depression: randomized controlled trial.BMJ2000; 321:536–539. (2 September.) [OpenUrl][1][Abstract/FREE Full Text][2] 2. 2.↵1. Philipp M, 2. Kohnen R, 3. Hiller KO .Hypericum extract versus imipramine or placebo in patients with moderate depression: randomised multi-centre study of treatment for eight weeks.BMJ1999; 319:1534–1538. [OpenUrl][3][Abstract/FREE Full Text][4] 3. 3.↵1. Cornwall PL, 2. Scott J .Partial remission in depressive disorders.Acta Psychiatr Scand1997; 95:265–271. [OpenUrl][5][PubMed][6][Web of Science][7] 4. 4.↵1. Kent JM .SNaRIs, NaSSAs, and NaRIs: new agents for the treatment of depression.Lancet2000; 355:911–918. [OpenUrl][8][CrossRef][9][PubMed][10][Web of Science][11] # Study design casts doubt on value of St John's wort in treating depression {#article-title-7} EDITOR—Although it is impressive to see a study in which hypericum is equivalent to an antidepressant, suggesting efficacy, the design of this study by Woelk et al makes it difficult for us to know the value of St John's wort for the treatment of depression.1 Firstly, imipramine is an outdated antidepressant. The current batch of selective serotonin reuptake inhibitors and atypical antidepressants have far fewer side effects and can be tailored to the specific needs and responses of the patient. Will hypericum be coupled with activating herbs (such as Gingko biloba or Siberian ginseng) or sedating ones (such as kava or valerian root) to achieve the same effect? This study strikes me as an example of statistical interest (yes, hypericum may be at least as effective as imipramine), but it has minimal practical clinical relevance. Secondly, the study ran for only six weeks. Most studies exploring the efficacy of an antidepressant run for a … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DWoelk%26rft.auinit1%253DH.%26rft.volume%253D321%26rft.issue%253D7260%26rft.spage%253D536%26rft.epage%253D539%26rft.atitle%253DComparison%2Bof%2BSt%2BJohn%2527s%2Bwort%2Band%2Bimipramine%2Bfor%2Btreating%2Bdepression%253A%2Brandomised%2Bcontrolled%2Btrial%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.321.7260.536%26rft_id%253Dinfo%253Apmid%252F10968813%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=321/7260/536&atom=%2Fbmj%2F322%2F7284%2F493.atom [3]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DPhilipp%26rft.auinit1%253DM.%26rft.volume%253D319%26rft.issue%253D7224%26rft.spage%253D1534%26rft.epage%253D1539%26rft.atitle%253DHypericum%2Bextract%2Bversus%2Bimipramine%2Bor%2Bplacebo%2Bin%2Bpatients%2Bwith%2Bmoderate%2Bdepression%253A%2Brandomised%2Bmulticentre%2Bstudy%2Bof%2Btreatment%2Bfor%2Beight%2Bweeks%2B%2595%2BCommentary%253A%2BHas%2Bhypericum%2Bfound%2Bits%2Bplace%2Bin%2Bantidepressant%2Btreatment%253F%26rft_id%253Dinfo%253Apmid%252F10591711%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=319/7224/1534&atom=%2Fbmj%2F322%2F7284%2F493.atom [5]: {openurl}?query=rft.jtitle%253DActa%2Bpsychiatrica%2BScandinavica%26rft.stitle%253DActa%2BPsychiatr%2BScand%26rft.aulast%253DCornwall%26rft.auinit1%253DP.%2BL.%26rft.volume%253D95%26rft.issue%253D4%26rft.spage%253D265%26rft.epage%253D271%26rft.atitle%253DPartial%2Bremission%2Bin%2Bdepressive%2Bdisorders.%26rft_id%253Dinfo%253Apmid%252F9150818%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/external-ref?access_num=9150818&link_type=MED&atom=%2Fbmj%2F322%2F7284%2F493.atom [7]: /lookup/external-ref?access_num=A1997WX14700001&link_type=ISI [8]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DKent%26rft.auinit1%253DJ.%2BM.%26rft.volume%253D355%26rft.issue%253D9207%26rft.spage%253D911%26rft.epage%253D918%26rft.atitle%253DSNaRIs%252C%2BNaSSAs%252C%2Band%2BNaRIs%253A%2Bnew%2Bagents%2Bfor%2Bthe%2Btreatment%2Bof%2Bdepression.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252899%252911381-3%26rft_id%253Dinfo%253Apmid%252F10752718%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [9]: /lookup/external-ref?access_num=10.1016/S0140-6736(99)11381-3&link_type=DOI [10]: /lookup/external-ref?access_num=10752718&link_type=MED&atom=%2Fbmj%2F322%2F7284%2F493.atom [11]: /lookup/external-ref?access_num=000085896000041&link_type=ISI

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction machine sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.

score de la tête « metaresearch » (Codex)0,009
score de la tête « metaresearch » (Gemma)0,018
Version: metacan-v3-hybrid-931329e0061cStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Sans objet · Signal consensuel: aucune
GenreSignal candidat: Commentaire · Signal consensuel: aucune
Score de désaccord entre enseignants0,010
Score d'incertitude au seuil0,045

Scores du classifieur distillé par catégorie (deux têtes)

CatégorieCodexGemma
Métarecherche0,0090,018
Méta-épidémiologie (sens strict)0,0010,000
Méta-épidémiologie (sens large)0,0070,005
Bibliométrie0,0010,001
Études des sciences et des technologies0,0000,001
Communication savante0,0020,001
Science ouverte0,0010,001
Intégrité de la recherche0,0030,004
Charge utile insuffisante (le modèle a refusé de juger)0,0100,001

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,069
Tête enseignante GPT0,350
Écart entre enseignants0,281 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeSans objet
Domainenon disponible
GenreCommentaire

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations7
Publié2001
Routes d'admission1
Résumé présentoui

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