Cochrane Reviews and Music Therapy Research Overview
This content delves into the significance of Cochrane reviews in the field of music therapy research, discussing key concepts, evidence-based practices, the Cochrane Collaboration, and current Cochrane reviews focusing on various music interventions for health conditions.
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COCHRANE REVIEWS AND MUSIC THERAPY RESEARCH Cheryl Dileo, PhD, MT-BC Carnell Professor of Music Therapy Director: Arts and Quality of Life Research Ctr. Coordinator: PhD Program in Music Therapy
Basic issues to be addressed How to understand Cochrane Reviews Including important concepts such as bias How to make use of this information in designing future research
Evidence-Based Practice Strides being taken to accumulate high quality evidence in field of music therapy Attempting to assure that procedures used in music therapy are: Safe Effective Cost-Effective
Cochrane Collaboration The Cochrane Collaboration international network of individuals and institutions review and analyze the best clinical trials synthesize them into regularly updated systematic reviews and meta-analyses. considered by many to be the Gold Standard, or the final word in the medical conversation on a topic.
Current Cochrane Reviews at Temple Music for stress and anxiety reduction in coronary heart disease patients (Bradt, Dileo & Potvin) (2013) Music therapy for end-of-life care (Bradt & Dileo) (2009) Music therapy for acquired brain injury (2010) (Bradt, Magee, Dileo, Wheeler, McGilloway) Music interventions for mechanically ventilated patients (Bradt & Dileo., 2010 update in press)
Music interventions for improving psychological and physical outcomes in cancer patients (Bradt, Dileo, Grocke & Magill) (2011) (being updated) Music for pre-operative anxiety (Bradt, Dileo & Shim) (2013)
Other Published Cochrane Reviews Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes (Laopaiboon,Lumbiganon, Martis,Vatanasapt,Somjaivong) (2009) Music for pain relief (Cepeda,Carr, Lau, Alvare, 2013) Music therapy for people with autism spectrum disorder Geretsegger , Elefant, M ssler Gold (2014) Music therapy for Depression (Maratos, Gold, Wang, Crawford) (2008) Music Therapy for People with Dementia (Vink,Bruinsma,Scholten) (2003) Music therapy for people with schizophrenia and schizophrenia-like disorders (M ssler, Chen, Heldal, Gold, 2011)
Cochrane Reviews Listening to music for improving sleep in adults with insomnia (Jespersen Koenig, Jennum and PetVuust, 2013 Music therapy for attention deficit hyperactivity disorder (ADHD) in children and adolescents (Zhang, Liu, An, You,Teng, Liu 2012)
Other Arts therapies Art therapy for people with dementia Deshmukh, Holmes, Cardno, 2014) Art therapy for schizophrenia or schizophrenia-like illnesses Ruddy, Milnes, 2005 Dance/movement therapy for improving psychological and physical outcomes in cancer patients (Bradt, Goodill, Dileo, 2011) Dance therapy for schizophrenia (Ren, Xia, 2013)
Understanding Cochrane Reviews SOME BASICS
Systematic Reviews Systematic reviews seek to collate all evidence that fits pre-specified eligibility criteria in order to address a specific research question. Systematic reviews aim to minimize bias by using explicit, systematic methods. The Cochrane Collaboration prepares, maintains and promotes systematic reviews to inform healthcare decisions
Types of studies Cochrane reviews typically include Randomized Controlled Trials Controlled Clinical Trials
Library of Medicine definition Randomized Controlled Trial involves at least one test treatment and one control treatment, concurrent enrolment and follow-up of the test- and control-treated groups, in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.
Library of Medicine Definition Controlled Clinical Trial Involves one or more test treatments at least one control treatment, specified outcome measures for evaluating the studied intervention, and a bias-free method for assigning patients to the test treatment.
Reporting Results- Risk of Bias In clinical trials, biases can be broadly categorized selection bias, performance bias, detection bias, attrition bias, reporting bias and other biases that do not fit into these categories.
A Common Classification Scheme for Bias Type of bias Description Relevant domains in the Collaboration s Risk of bias tool Sequence generation. Allocation concealment. Selection bias. Systematic differences between baseline characteristics of the groups that are compared. Performance bias. Systematic differences between groups in the care that is provided, or in exposure to factors other than the interventions of interest. Systematic differences between groups in how outcomes are determined. Systematic differences between groups in withdrawals from a study. Systematic differences between reported and unreported findings. Blinding of participants and personnel. Other potential threats to validity. Detection bias. Blinding of outcome assessment. Other potential threats to validity. Attrition bias. Incomplete outcome data Reporting bias. Selective outcome reporting (see also Chapter 10).
Understanding Results Effect size Confidence Intervals Heterogeneity
Music for stress and anxiety reduction in coronary heart disease patients Bradt, Dileo, Potvin, 2013
MusicCHD Purpose: to assess the effects of music interventions with standard care vs. standard care alone On psychological responses physiological responses In people with heart disease.
Studies Included 26 trials- 1369 Ss Representing US, Australia, Denmark, Hong Kong, S, Korea, Sweden, Iran 3 trials - music therapy 23 trials - music medicine
Music Medicine vs. Music Therapy Use of music by medical professionals No therapeutic process No relationship established through the music Primarily pre- recorded music listening Trained/ Credentialed music therapist Therapeutic process (assessment, treatment, evaluation Relationship with pt through music Range of music experiences
Data Analysis Were there significant differences between patients who had music vs. no music/standard care? What was size of difference? Small? Moderate? Large? Did the studies differ significantly in their results? Homogenous or heterogenous?
Music Interventions for Mechanically Ventilated Patients BRADT, DILEO & GROCKE, 2010) (BRADT & DILEO, IN PRESS)
MusicMechanically Ventilated Patients PURPOSE Compare the effects of standard care + music therapy or music medicine interventions with standard care alone on anxiety in mechanically ventilated patients.
MusicMechanically Ventilated Patients 14 studies USA (5) China (3) and 1 each from Taiwan, Canada, Germany, Netherlands, Turkey & France 805 participants 13 studies- music medicine 1 study-music therapy
Music Therapy for Acquired Brain Injury BRADT, MAGEE, DILEO, WHEELER, MCGILLOWAY , 2010
MT/ABI Seven studies (184 participants, 54% male) All Music Therapy 3 US, 1 South Korea, 1 Germany, 1 Australia, 1 US and Germany
Music Interventions for Improving Psychological and Physical Outcomes in Cancer Patients BRADT, DILEO, GROCKE, MAGILL, 2011 BRADT, DILEO, MAGILL (IN PROGRESS)
Music.Cancer Patients 29 studies (1880 participants; 33% male) 17 US, 6 China, 2 Italy, 1 Iran, 1 Spain, 1 Taiwan, 1 Vietnam 12 music therapy 17 music medicine 9 chemotherapy or radiation 8 surgery or procedure 12 general 4 pediatric
Music for Preoperative Anxiety BRADT, DILEO, SHIM (2013)
Music.Preoperative Anxiety 26 Trials (2051 Participants) Inpatients, outpatients, emergency, non- emergency Patients undergoing major as well as minor surgical procedures General, endoscopic, gynecological, urogenital, orthopedic,cosmetic, caesarean, cardiac, opthalmic, septorhinoplastic, gastric
Music.Preoperative Anxiety 54% female; 46% male participants (Average 48.7 years) Studies included USA (9); Taiwan (5); Hong Kong (3); China (3); Turkey (2); Poland (2); Malaysia (1); Israel (1) All studies classified as Music Medicine Most with one 20-30 minute listening session 2 with multiple listening sessions
Music Therapy for End-of-Life Care BRADT & DILEO, 2010
Music Therapy..EOL PURPOSE To compare the effects of music therapy combined with standard care with standard care alone, or standard care and other therapies.
Music Therapy.EOL Studies Included 5 studies (175 participants, 49% male) All Music Therapy 4 US, 1 Australia
Contact cdileo@temple.edu www.temple.edu/musictherapy www.temple.edu/boyer/researchcenter
