A Survey of 1144 <scp>ECT</scp> Recipients, Family Members and Friends: Does <scp>ECT</scp> Work?
Bibliographic record
Abstract
The last placebo-controlled ECT trial for depression occurred in 1985. While awaiting trials that meet today's standards of evidence-based medicine, this paper presents the responses, to an online survey, of 858 ECT recipients and 286 family members and friends, from 44 countries, on five effectiveness measures. The majority (55%-71%) reported either no benefit or a negative outcome on the five measures. The percentages reporting some benefit were: helped the specific problem for which ECT was given-45%; improved mood-41%; generally 'helpful'-41%; improved 'quality of life'-29%; reduced suicidality-33%. Respondents were, unusually, given the option, on four of these measures, to report that the variable had been made worse. The results were: specific problem made worse-37%; worse mood-29%; reduced quality of life-62%; and increased suicidality-19%. The findings were consistent with responses from family and friends. It is striking that nearly half (49%) reported that their quality of life was made 'much worse' (22%) or 'very much worse' (27%) by ECT. A partial explanation of this alarming outcome is that quality of life encompasses the adverse effects of ECT alongside any benefits. In conjunction with the absence of evidence that ECT is more effective than placebo, and the known long-term adverse effects on memory, these survey findings lead us to recommend a suspension of ECT in clinical settings pending independent large-scale placebo-controlled studies to determine whether ECT has any effectiveness relative to placebo, against which the many serious adverse effects can be weighed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".