Can early stopping procedures impact significantly on the efficiency of clinical trials without serious loss of information?

Meaning-making intervention during breast or colorectal cancer treatment improves self-esteem, optimism, and self-efficacy

Existential issues often accompany a diagnosis of cancer and remain one aspect of psychosocial oncology care for which there is a need for focused, empirically tested interventions. This study examined the efficacy of a novel psychological intervention specifically designed to address existential issues through the use of meaning-making coping strategies on psychological adjustment to cancer. Eighty-two breast or colorectal cancer patients were randomly chosen to receive routine care (control group) or up to four sessions that explored the meaning of the emotional responses and cognitive appraisals of each individual's cancer experience within the context of past life events and future goals (experimental group). This paper reports the results from 74 patients who completed and returned pre- and post-test measures for self-esteem, optimism, and self-efficacy. After controlling for baseline scores, the experimental group participants demonstrated significantly higher levels of self-esteem, optimism, and self-efficacy compared to the control group. The results are discussed in light of the theoretical and clinical implications of meaning-making coping in the context of stress and illness.

Interim analyses in clinical research

Interim analyses are those that occur before the scheduled completion of a clinical study. The motivation for such analyses may be to see whether conclusive evidence is available concerning the aims of the study, or it may be simple curiosity. Statisticians disagree about the impact that interim analyses have on inferences that can be drawn from the study. The significance testing view insists that conclusions from a study with interim analyses are different than from one without--even though the data are identical. In the Bayesian view there is no penalty for interim analyses: study results can even be monitored continually without changing the conclusions. Both views are explained and recommendations for designing and analyzing studies with interim analyses are made.