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STAR*D: Helping to Close the Gap Between Science and Practice

Dr. Shern is president and chief executive officer of Mental Health America, 2000 N. Beauregard St., 6th Floor, Alexandria, VA 22311 (e-mail: dshern{at}mentalhealth america.net), where Ms. Moran was affiliated when this work was done. She is currently associate director of government affairs, Eisai Corp. of America, Washington, D.C. This commentary is part of a special section on the STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression) and the implications of its findings for practice and policy. Grayson S. Norquist, M.D., M.S.P.H., served as guest editor of the special section.

Practical clinical trials, such as STAR*D (Sequenced Treatment Alternatives to Relieve Depression), extend the traditional randomized controlled trial to real-world settings. Consumers and clinicians should be encouraged by STAR*D's 70% remission rate and should realize that for many participants remission required medication switching and augmentation. Policy makers should recognize the importance of easy access to a full range of treatments. Researchers should be sobered by the high attrition rate and the 30% of participants who did not achieve remission. Although more such practical trials are needed, future work must more meaningfully involve consumers in design, analysis, and interpretation.

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				G. S. Norquist Introduction to the STAR*D Special Section Psychiatr Serv, November 1, 2009; 60(11): 1437 - 1438. [Full Text] [PDF]

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