{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:29:00Z","timestamp":1761514140190,"version":"build-2065373602"},"reference-count":44,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,11,29]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Major depression is a leading cause of disability and has been associated with adverse effects in older persons. While many pharmacological and non-pharmacological interventions have been shown to be effective to address major depression in older persons, there has not been a meta-analysis that consolidates all the available interventions and compare the relative benefits of these available interventions. In this study, we aim to conduct a systematic review and network meta-analysis to compare the efficacy and acceptability of all the known pharmacological and non-pharmacological interventions for major depression in older persons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>We will search Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health, Cochrane Central Register of Controlled Trials and references of other review articles for articles related to the keywords of \u2018randomised trial\u2019, \u2018major depression\u2019, \u2018older persons\u2019 and \u2018treatments\u2019. Two reviewers will independently select the eligible articles. For each included article, the two reviewers will independently extract the data and assess the risk of bias using the Cochrane revised tool for risk of bias. Bayesian network meta-analyses will be conducted to pool the depression scores (based on standardised mean difference) and the all-cause discontinuation across all included studies. The ranking probabilities for all interventions will be estimated and the hierarchy of each intervention will be summarised as surface under the cumulative ranking curve (SUCRA). Meta-regression and sub-group analyses will also be performed to evaluate the effect of study-level covariates. The quality of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The results will be disseminated through conference presentations and peer-reviewed publications. They will provide the consolidated evidence to inform clinicians on the best choice of intervention to address major depression in older persons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"CRD42017075756\">CRD42017075756<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019819","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T00:17:00Z","timestamp":1516580220000},"page":"e019819","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative efficacy and acceptability of interventions for major depression in older persons: protocol for Bayesian network meta-analysis"],"prefix":"10.1136","volume":"8","author":[{"given":"Tau Ming","family":"Liew","sequence":"first","affiliation":[{"name":"Department of Geriatric Psychiatry, Institute of Mental Health, Singapore"},{"name":"Psychotherapy Unit, Institute of Mental Health, Singapore"},{"name":"Saw Swee Hock School of Public Health, National University of Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cia Sin","family":"Lee","sequence":"additional","affiliation":[{"name":"SingHealth Polyclinics, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,21]]},"reference":[{"key":"2025101810161421000_8.1.e019819.1","unstructured":"World Health Organization. The global burden of disease. Switzerland: World Health Organization, 2004."},{"key":"2025101810161421000_8.1.e019819.2","unstructured":"World Health Organization. Global health estimates 2015: disease burden by cause, age, sex, by country and by region, 2000-2015. Geneva: World Health Organization, 2016."},{"key":"2025101810161421000_8.1.e019819.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1402180"},{"key":"2025101810161421000_8.1.e019819.4","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/58.3.M249"},{"key":"2025101810161421000_8.1.e019819.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2012.09.004"},{"key":"2025101810161421000_8.1.e019819.6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1999.00326.x"},{"key":"2025101810161421000_8.1.e019819.7","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70051-7"},{"key":"2025101810161421000_8.1.e019819.8","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-014-0371-z"},{"key":"2025101810161421000_8.1.e019819.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1282"},{"key":"2025101810161421000_8.1.e019819.10","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.13030325"},{"key":"2025101810161421000_8.1.e019819.11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jad.2016.06.013","article-title":"Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder: a systematic review and a meta-analysis","volume":"205","author":"Tham","year":"2016","journal-title":"J Affect Disord"},{"key":"2025101810161421000_8.1.e019819.12","doi-asserted-by":"publisher","DOI":"10.1097\/01.JGP.0000308883.64832.ed"},{"key":"2025101810161421000_8.1.e019819.13","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13395"},{"key":"2025101810161421000_8.1.e019819.14","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10r06531"},{"key":"2025101810161421000_8.1.e019819.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2012.04166.x"},{"key":"2025101810161421000_8.1.e019819.16","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4358"},{"key":"2025101810161421000_8.1.e019819.17","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1620"},{"key":"2025101810161421000_8.1.e019819.18","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.maturitas.2014.05.027","article-title":"Managing depression in older age: psychological interventions","volume":"79","author":"Cuijpers","year":"2014","journal-title":"Maturitas"},{"key":"2025101810161421000_8.1.e019819.19","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1719"},{"key":"2025101810161421000_8.1.e019819.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0184666","article-title":"Non-pharmacological treatment for depressed older patients in primary care: a systematic review and meta-analysis","volume":"12","author":"Holvast","year":"2017","journal-title":"PLoS One"},{"key":"2025101810161421000_8.1.e019819.21","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ijnurstu.2016.02.006","article-title":"The effectiveness of non-pharmacological interventions in older adults with depressive disorders: a systematic review","volume":"58","author":"Ap\u00f3stolo","year":"2016","journal-title":"Int J Nurs Stud"},{"key":"2025101810161421000_8.1.e019819.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-014499","article-title":"Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials","volume":"7","author":"Sukhato","year":"2017","journal-title":"BMJ Open"},{"key":"2025101810161421000_8.1.e019819.23","first-page":"943","article-title":"Network meta-analysis: a technique to gather evidence from direct and indirect comparisons","volume":"15","author":"Tonin","year":"2017","journal-title":"Pharm Pract"},{"key":"2025101810161421000_8.1.e019819.24","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"2025101810161421000_8.1.e019819.25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647"},{"key":"2025101810161421000_8.1.e019819.26","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716659276"},{"key":"2025101810161421000_8.1.e019819.27","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716659417"},{"key":"2025101810161421000_8.1.e019819.28","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716659418"},{"key":"2025101810161421000_8.1.e019819.29","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716660033"},{"key":"2025101810161421000_8.1.e019819.30","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716660290"},{"key":"2025101810161421000_8.1.e019819.31","unstructured":"Higgins JPT , Sterne JAC , Savovi\u0107 J , et al . A revised tool for assessing risk of bias in randomized trials. In: Chandler J , McKenzie J , Boutron I , eds. Cochrane methods cochrane database of systematic reviews, 2016."},{"key":"2025101810161421000_8.1.e019819.32","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"2025101810161421000_8.1.e019819.33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-985X.2008.00552.x"},{"key":"2025101810161421000_8.1.e019819.34","unstructured":"Guyatt G . Users guides to the medical literature: a manual for evidence-based clinical practice. McGraw-Hill Education, 2014."},{"key":"2025101810161421000_8.1.e019819.35","first-page":"719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"Mantel","year":"1959","journal-title":"J Natl Cancer Inst"},{"key":"2025101810161421000_8.1.e019819.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"2025101810161421000_8.1.e019819.37","doi-asserted-by":"crossref","unstructured":"Burnham KP , Anderson DR . Model selection and multimodel inference: a practical information-theoretic approach. New York: Springer, 2003.","DOI":"10.1007\/b97636"},{"key":"2025101810161421000_8.1.e019819.38","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3767"},{"key":"2025101810161421000_8.1.e019819.39","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/jrsm.1167","article-title":"Automated generation of node-splitting models for assessment of inconsistency in network meta-analysis","volume":"7","author":"van Valkenhoef","year":"2016","journal-title":"Res Synth Methods"},{"key":"2025101810161421000_8.1.e019819.40","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0076654","article-title":"Graphical tools for network meta-analysis in STATA","volume":"8","author":"Chaimani","year":"2013","journal-title":"PLoS One"},{"key":"2025101810161421000_8.1.e019819.41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-985X.2009.00629.x"},{"key":"2025101810161421000_8.1.e019819.42","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1177\/1536867X1501500402","article-title":"Visualizing assumptions and results in network meta-analysis: the network graphs package","volume":"15","author":"Chaimani","year":"2015","journal-title":"Stata J"},{"key":"2025101810161421000_8.1.e019819.43","unstructured":"Schunemann H , Brozek J , Guyatt G , et al . GRADE handbook for grading quality of evidence and strength of recommendation. 2013 http:\/\/gdt.guidelinedevelopment.org\/app\/ (assessed 22 Nov 2016)."},{"key":"2025101810161421000_8.1.e019819.44","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-019819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:16:25Z","timestamp":1760807785000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-019819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,1,21]]},"published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1136\/bmjopen-2017-019819"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-019819","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2018,1]]}}}