Table 6 Classification of meta-analytic evidence ranked by class of evidence, number of included primary studies, and date of publicationa.

From: Metacognitive training for psychosis (MCT): a systematic meta-review of its effectiveness

Outcome

Meta-Analysis ID

Interventionb/Control

RCT; nRCT

n cases

Hedges’ g [95% CI]c

p-valued

I2 (%)

PI 95% CI

SSE/ESB/LS

CE

Overall symptoms

Penney [26] [proximal]

MCT vs TAU (42.1%); MCT vs CR (10.52%); MCT vs ST (2.63%); MCT vs CBR (2.63%); MCT only (13.15%); MCT vs AC (15.78%); MCT vs PE (5.26%); MCT vs WL (7.89%)

25; 12

932

0.392 [0.245, 0.538]

0.000000162

65.73

[–0.368, 1.151]

no/no/no

IV

 

Penney [26] [distal]

MCT vs TAU (38.46%); MCT vs CR (7.69%); MCT vs ST (3.84%); MCT vs CBR (3.84%); MCT vs PE (7.69%); MCT vs AC (15.38%); MCT only (19.23%); MCT vs WL (3.84%)

19; 7

645

0.313 [0.197, 0.43]

0.00000014

46.729

[–0.081, 0.707]

no/no/no

IV

 

Burlingame [32]

MCT vs ND (20%); MCT vs TAU (20%); MCT vs CogPack (20%); MCT vs WL (20%); MCT vs PE (20%)

5; 0

162

0.142 [–0.08, 0.363]

0.209

0

[–0.218, 0.501]

no/no/no

ns

Positive symptoms

Penney [26]

MCT vs TAU (41.66%); MCT vs CogPack (8.33%); MCT vs CR (2.77%); MCT vs ST (2.77%); MCT vs CBR (2.77%); MCT only (13.88%); MCT vs OT (2.77%); MCT vs MCT + control (2.77%); MCT vs PE (5.55%); MCT vs WL (5.55%); MCT vs AC (8.33%)

23; 13

894

0.473 [0.295, 0.651]

0.00000019

74.635

[–0.483, 1.429]

no/no/no

IV

 

Philipp [24]

MCT vs ND (10.05%); MCT vs CogPack (15.78%); MCT vs TAU (52.63%); MCT vs CR (5.26%); MCT vs ST (5.26%); MCT vs WL (5.26%); MCT vs PE (5.26%)

15; 4

531

0.302 [0.117, 0.486]

0.00135

49.248

[–0.317, 0.92]

no/no/no

IV

 

Sauvé [25]

MCT vs ND (5.88%); MCT vs CogPack (17.64%); MCT vs TAU (41.17%); MCT vs CR (5.88%); MCT vs ST (5.88%); MCT only (5.88%); MCT vs MCT + control (5.88%); MCT+CR vs AC+WL (5.88%); MCT vs WL (5.88%)

9; 8

480

0.273 [0.099, 0.446]

0.00207

47.317

[–0.275, 0.821]

no/no/no

IV

 

EichnerBerna [22]

MCT vs ND (9.09%); MCT vs TAU (45.45%); MCT vs ST (9.09%); MCT vs CogPack (18.18%); MCT vs WL (18.18%)

9; 2

245

0.361 [0.157, 0.565]

0.00052

7.127

[–0.023, 0.746]

no/no/no

IV

 

Burlingame [32]

MCT vs ND (12.5%); MCT vs TAU (37.5%); MCT vs SS (12.5%); MCT vs CogPack (12.5%); MCT vs PE (12.5%); MCT vs group-based therapy (12.5%)

8; 0

241

0.19 [0.01, 0.37]

0.0385

0

[–0.035, 0.415]

no/no/no

IV

 

Jiang [30]

MCT vs TAU (50%); MCT vs CogPack (25%); MCT vs ST (25%)

4; 0

129

0.406 [0.054, 0.758]

0.0238

34.301

[–0.808, 1.619]

yes/no/no

IV

 

vanOosterhout [28,33]

MCT vs TAU (66.66%); MCT vs ST (11.11%); MCT vs CogPack (22.22%)

6; 3

209

0.26 [–0.003, 0.522]

0.0524

41.038

[–0.412, 0.931]

no/no/no

ns

Delusions

Penney [26]

MCT vs CogPack (13.04%); MCT vs TAU (56.52%); MCT vs CR (8.69%); MCT vs ST (4.34%); MCT vs CBR (4.34%); MCT only (8.69%); MCT vs AC (4.34%)

13; 9

621

0.639 [0.389, 0.889]

0.000000554

80.01

[–0.503, 1.781]

no/no/no

IV

 

Liu [23]

MCT vs CogPack (27.27%); MCT vs ST (9.09%); MCT vs TAU (54.54%); MCT vs WL (9.09%)

11; 0

334

0.38 [0.125, 0.635]

0.00349

64.841

[–0.422, 1.183]

no/no/no

IV

 

EichnerBerna [22]

MCT vs TAU (72.72%); MCT vs ST (9.09%); MCT vs CogPack (18.18%); MCT vs WL (9.09%)

9; 2

334

0.407 [0.066, 0.748]

0.0192

75.93

[–0.776, 1.59]

no/no/no

IV

 

vanOosterhout [28,33]

MCT vs SC (14.28%); MCT vs TAU (57.14%); MCT vs CogPack (28.57%)

7; 0

224

0.234 [–0.035, 0.502]

0.0884

49.865

[–0.489, 0.956]

no/no/no

ns

 

Jiang [30]

MCT vs TAU (50%); MCT vs CogPack (25%); MCT vs ST (25%)

4; 0

196

0.127 [–0.21, 0.464]

0.459

60.961

[–1.222, 1.476]

no/no/no

ns

Hallucinations

Penney [26]

MCT vs ST (11.11%); MCT vs CBR (11.11%); MCT vs TAU (33.33%); MCT only (22.22%); MCT vs CR (22.22%)

6; 3

271

0.265 [0.098, 0.432]

0.00185

6.108

[–0.095, 0.625]

no/no/no

IV

Negative symptoms

Penney [26]

MCT vs TAU (5.88%); MCT vs CR (11.76%); MCT vs CBR (5.88%); MCT vs TAU (29.41%); MCT vs AC (23.52%); MCT vs WL (5.88%); MCT only (11.76%); MCT vs RA (5.88%)

13; 4

415

0.233 [0.1, 0.366]

0.000592

34.777

[–0.125, 0.591]

no/no/no

IV

  1. RCT randomized controlled trial, nRCT non-randomized controlled trial, SSE small study effect, ESB excess significance bias, LS largest study, AttCG attention control group, TAU treatment as usual, AC active control, ND newspaper discussion, WL waitlist, PE psychoeducation, ST supportive therapy, CR cognitive remediation therapy, CBR community-based rehabilitation, RA recreational activity, OT occupational therapy, NA not applicable / number of studies not sufficient for calculations.
  2. aAll calculations were performed using metaumbrella.org, a statistical tool, and its associated R-package designed for the use in meta-reviews; for all meta-analyses we used the REML/TESSPSST procedure. When calculating all meta-analyses with the latter setting, results converged and the level of significance remained unchanged.
  3. bMetacognitive training (MCT) and all its adaptations are listed under the umbrella term MCT.
  4. cAll calculations were performed using unweighted effect sizes; thus, results may differ from the meta-analyses’ original results by a one-hundredth decimal. Meta-analyses that utilized weighted effect sizes include Jiang et al. [30] and Eichner and Berna [22].
  5. dAll p-values were rounded to the nearest one-hundredth decimal.
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