TY - JOUR
T1 - Circumstances under which practice does not make perfect
T2 - A review of the practice effect literature in schizophrenia and its relevance to clinical treatment studies
AU - Goldberg, Terry E.
AU - Keefe, Richard S.E.
AU - Goldman, Robert S.
AU - Robinson, Delbert G.
AU - Harvey, Philip D.
PY - 2010/4
Y1 - 2010/4
N2 - In this article, we review the literature on practice effects in schizophrenia, an underappreciated confound in interpreting cognitive improvement in clinical trials. We first examine claims regarding first-and second-generation antipsychotic medications as cognitive enhancers, and follow it with a discussion of recent studies demonstrating how practice or placebo effects may drive positive findings. Thus, this review suggests that many previous findings can be reinterpreted in this light. Critically, we also make several suggestions about test construction, study design, and statistical analyses that the field might use to overcome this potential confound. Our suggestions may also have implications for drug discovery and regulatory approval of cognitive-enhancing adjunctive agents, in terms of study design and/or test psychometric characteristics, including the development of tests that are relatively insensitive to practice-related changes. Such advances might be important for improving the methodology involved in the assessment of cognitive change in treatment studies.
AB - In this article, we review the literature on practice effects in schizophrenia, an underappreciated confound in interpreting cognitive improvement in clinical trials. We first examine claims regarding first-and second-generation antipsychotic medications as cognitive enhancers, and follow it with a discussion of recent studies demonstrating how practice or placebo effects may drive positive findings. Thus, this review suggests that many previous findings can be reinterpreted in this light. Critically, we also make several suggestions about test construction, study design, and statistical analyses that the field might use to overcome this potential confound. Our suggestions may also have implications for drug discovery and regulatory approval of cognitive-enhancing adjunctive agents, in terms of study design and/or test psychometric characteristics, including the development of tests that are relatively insensitive to practice-related changes. Such advances might be important for improving the methodology involved in the assessment of cognitive change in treatment studies.
KW - Clinical pharmacology/trials
KW - Cognition
KW - Learning and memory
KW - Practice effects
KW - Schizophrenia/antipsychotics
UR - http://www.scopus.com/inward/record.url?scp=77949540094&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77949540094&partnerID=8YFLogxK
U2 - 10.1038/npp.2009.211
DO - 10.1038/npp.2009.211
M3 - Review article
C2 - 20090669
AN - SCOPUS:77949540094
VL - 35
SP - 1053
EP - 1062
JO - Neuropsychopharmacology
JF - Neuropsychopharmacology
SN - 0893-133X
IS - 5
ER -