{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:33:52Z","timestamp":1789472032118,"version":"build-2803163510"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Oxford Cognitive Health Clinical Research Facility","award":["RP-2017-08-ST2-006"],"award-info":[{"award-number":["RP-2017-08-ST2-006"]}]},{"name":"NIHR Oxford and Thames Valley Applied Research Collaboration"},{"name":"NIHR Oxford Health Biomedical Research Centre","award":["BRC-1215-20005"],"award-info":[{"award-number":["BRC-1215-20005"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The magnitude of the superiority of antipsychotics over placebo is debated. One reason is that the effect-size index which is usually used in meta-analyses is in standard deviation units. Many other indices, some of which are more intuitive, exist.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We explain the formulae, advantages, and limitations of 13 effect-size indices: Mean Difference (MD), Standardized-Mean-Difference (SMD), Correlation Coefficient, Ratio-of-Means (RoM, endpoint and change data), Improvement Fraction (IF), Drug-Response Fraction (DRF), Minimally-Clinically-Important-Difference-Units (MCIDU), Number-Needed-to-Treat-derived from SMD (NNT), Odds Ratio (OR), Relative Risk (RR), and Risk Difference (RD) derived from SMD, Drug-response and Placebo-response in percent. We applied these indices to meta-analyses comparing antipsychotic drugs with placebo for acute schizophrenia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The difference of all antipsychotics pooled vs placebo (105 trials with 22741 participants) was: MD 9.4 (95% CI 8.4,10.2) PANSS points, SMD 0.47 (0.42,0.51), Correlation coefficient 0.23 (0.21,0.25), RoM endpoint 0.83 (0.81,0.85), RoM change 1.94 (1.84,2.02), IF (%) 49 (46,51), DRF (%) 94 (84,102), MCIDU 0.63 (0.56,0.68), NNT 5 (5,6), OR 2.34 (2.14, 2.52), RR 1.67 (1.59,1.73), RD 20% (18\u201322), and 50% (48, 52) improved on drug compared to 30% on placebo. Results of individual drugs compared to placebo are presented, as well.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Taken together these indices show a substantial, but not a large superiority of antipsychotics compared to placebo. The general chronicity of the patients in the trials must be considered. Future meta-analyses should report other effect size indices in addition to the Standardized-Mean-Difference, in particular percentage responders in the drug and placebo groups. They can be easily derived and would enhance the interpretation of research findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/schbul\/sbab094","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T19:33:20Z","timestamp":1626809600000},"page":"27-36","source":"Crossref","is-referenced-by-count":22,"title":["How Efficacious Are Antipsychotic Drugs for Schizophrenia? An Interpretation Based on 13 Effect Size Indices"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4934-4352","authenticated-orcid":false,"given":"Stefan","family":"Leucht","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany"},{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-2039","authenticated-orcid":false,"given":"Spyridon","family":"Siafis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf R","family":"Engel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, School of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Schneider-Thoma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Bighelli","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-8321","authenticated-orcid":false,"given":"Andrea","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshi A","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Human Behavior and Department of Clinical Epidemiology, Graduate School of Medicine\/School of Public Health, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA"},{"name":"Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"issue":"10202","key":"2022012114123538600_CIT0001","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(19)31135-3","article-title":"Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis","volume":"394","author":"Huhn","year":"2019","journal-title":"Lancet"},{"key":"2022012114123538600_CIT0002","doi-asserted-by":"crossref","DOI":"10.1057\/9781137277442","volume-title":"The Bitterest Pills: The Troubling Story of Antipsychotic Drugs","author":"Moncrieff","year":"2013"},{"key":"2022012114123538600_CIT0003","doi-asserted-by":"crossref","first-page":"h2435","DOI":"10.1136\/bmj.h2435","article-title":"Does long term use of psychiatric drugs cause more harm than good?","volume":"350","author":"G\u00f8tzsche","year":"2015","journal-title":"BMJ."},{"key":"2022012114123538600_CIT0004","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.schres.2005.07.025","article-title":"Comparative efficacy of antipsychotics in the treatment of schizohrenia: a critical assessment","volume":"79","author":"Tandon","year":"2005","journal-title":"SchizophrRes."},{"key":"2022012114123538600_CIT0005","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1988","edition":"2"},{"issue":"1","key":"2022012114123538600_CIT0006","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1503\/cmaj.150430","article-title":"Do clinicians understand the size of treatment effects? 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