Identifying attendance patterns in a smoking cessation treatment and their relationships with quit success

May combine two claims.

Because early abstinence success predicts continued abstinence, Titrators who remained engaged in the exercise intervention through quit week may have benefited comparably to Completers despite lower overall attendance.

“Since success with abstinence within the first 24 hours after quit is predictive of continued abstinence (Perkins, 2014), Titrators who were likely to remain engaged in the exercise intervention through quit week may have benefited comparably to Completers despite lower overall attendance.”

• cites Perkins, 2014 sourcePartly supported

  Section 3.1 (page not specified) reports that the number of quit days in the first week predicts later quit status and proposes at least 24 hours of abstinence as a likely surrogate measure of drug efficacy. It does not specifically establish that abstinence within the first 24 hours predicts continued abstinence. The exercise-intervention comparison is the citing authors’ inference, not a claim attributed to Perkins. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

May combine two claims.

The parent trial's core outcome analysis showed that high-AS participants randomized to exercise were more likely to remain abstinent after quit day, and session attendance had an overall positive association with abstinence.

“The core outcome analysis showed that participants high in AS randomized to exercise were more likely to remain abstinent following quit day and session attendance showed an overall positive association with abstinence (Smits et al., 2016).”

• cites Smits et al., 2016 sourceSupported

May combine two claims.

The findings expand on the main outcome paper by showing that the relation between attendance patterns and treatment success may be non-linear and may depend on the type of intervention.

“The findings reported here expand on those reported in the main outcome paper (Smits et al., 2016) by showing that the relation between attendance patterns and treatment success may not be linear and, importantly, may depend on the type of intervention.”

• cites Smits et al., 2016 sourceSupported

Classified as probably not a substantial claim. May combine two claims.

In another treatment trial for comorbid PTSD and SUD, a person-centered analysis derived early dropout, titration, and completion patterns, and treatment titration was not associated with poorer outcomes relative to completion.

“Another treatment trial for comorbid PTSD and SUD used a person-centered approach to empirically derive distinct attendance patterns of early dropout, titration, and completion—importantly; treatment titration was not associated with poorer outcomes relative to completion (Hien et al., 2012).”

• cites Hien et al., 2012 sourceSupported

May combine two claims.

In some cases, greater session attendance or treatment completion has been positively associated with outcomes, but this association is not ubiquitous, suggesting individual differences in dose-response.

“In some cases, a greater number of sessions attended or treatment completion have shown positive associations with outcomes (Baker et al., 2006; Fiore, 2008; Smits et al., 2016; Whiteley et al., 2012), but this is not ubiquitous, suggesting individual differences in dose-response exist (Baldwin et al., 2009; Barkham et al., 2006; Owen et al., 2016; Reese et al., 2011).”

• cites Baker et al., 2006 sourceSupported
• cites Fiore, 2008Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Smits et al., 2016 sourceSupported

May combine two claims.

Exercise may help smoking cessation by reducing anxiety during acute withdrawal, which may be most pronounced after the initial quit attempt.

“Exercise may assist smoking cessation by mitigating anxiety during acute withdrawal symptoms (Leventhal and Zvolensky, 2015), which may be most pronounced after the initial quit attempt.”

• cites Leventhal and Zvolensky, 2015 sourcePartly supported

  The Anxiety Sensitivity section (page unavailable) reports that anxiety-related withdrawal symptoms are more pronounced early in abstinence and discusses anxiety-sensitivity interventions that may aid cessation. It does not say that exercise reduces withdrawal anxiety or helps people quit through that mechanism; its mention of vigorous exercise concerns prevention of smoking initiation, not cessation. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

In a trial of prolonged exposure with naltrexone for comorbid PTSD and alcohol dependence, both fast and slow PTSD symptom improvement and fast drinking improvement were associated with early dropout.

“in a clinical trial of prolonged exposure with naltrexone for comorbid posttraumatic stress disorder (PTSD) and alcohol dependence, both fast and slow rates of PTSD symptom improvement, as well as fast rates of drinking improvement, were each associated with early dropout (Zandberg et al., 2016).”

• cites Zandberg et al., 2016 sourcePartly supported

  The Abstract Results and Discussion report higher dropout with both very fast and very slow PTSD improvement among participants with high baseline PTSD severity, and with faster drinking improvement among participants receiving prolonged exposure. The claim omits those conditions and calls the outcome “early dropout,” whereas the reported associations concern dropout during treatment, not specifically early dropout. The Methods also show that prolonged exposure and naltrexone were separate randomized factors, not a treatment everyone received together; page numbers are unavailable in our copy. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

Other studies show rapid benefits of exercise on anxiety, mood, and anxiety sensitivity.

“Given evidence of rapid benefits from exercise on anxiety, mood, and anxiety sensitivity in other studies (Medina et al., 2014; Smits et al., 2008)”

• cites Medina et al., 2014 sourceSupported
• cites Smits et al., 2008 sourceSupported

May combine two claims.

During active attendance weeks, 63% of participants attended all three weekly sessions, 25% attended two, and 12% attended one.

“63% attended all 3 weekly sessions, 25% attended 2 out of the 3 weekly sessions, and 12% attended only one of the 3 weekly sessions.”

May combine two claims.

A three-class latent class growth analysis solution fit the weekly attendance data better than a single pattern, with the lowest information criteria, entropy of 0.96, and a significant adjusted Lo-Mendel-Rubin likelihood ratio test (p=.01).

“The 3-class LCGA provided the best fit with lowest information criteria, high entropy (0.96) suggestive of strong delineation of classes, and a significant adjusted Lo-Mendel-Rubin likelihood ratio test, p=.01.”

Classified as probably not a substantial claim.

The abstinence analyses followed an intent-to-treat approach recommended for smoking cessation trials.

“Following Smits et al., (2016) two dichotomous measures of smoking behavior (PPA and PA) were examined in a three-phase (i.e., pre-quit, post-quit, post-treatment) generalized linear mixed model (GLMM) following the intent-to-treat approach recommended for smoking cessation trials (Hall et al., 2001).”

• cites Hall et al., 2001 sourceNot checked — no full text of the source

May combine two claims.

The original study was not designed to compare intervention lengths, so the results reflect participant-determined attendance patterns rather than prescribed treatment dosage.

“The original study was not designed to compare intervention lengths, thus results reflect participant-determined attendance patterns as opposed to “prescribed” treatment dosage.”

Classified as probably not a substantial claim.

The Good Enough Level model proposes that optimal treatment dosage varies with individual improvement rates, so patients who improve quickly may self-modulate dosage by discontinuing early.

“The Good Enough Level (GEL) model posits that optimal treatment dosage varies as a function of individual improvement rates such that patients who improve quickly may self-modulate treatment dosage via early discontinuation (Owen et al., 2016; Reese et al., 2011).”

• cites Owen et al., 2016 sourceNot checked — no full text of the source
• cites Reese et al., 2011 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The abstinence analysis was restricted to Completers versus Titrators because Droppers withdrew before quit week.

“Subsequent analysis of the relation between treatment attendance pattern and abstinence was restricted to the Completer versus Titrator since Droppers withdrew prior to quit week.”

May combine two claims.

The present findings show that treatment attendance patterns can be empirically derived and related to efficacy, generating testable hypotheses.

“Together, the present findings show that treatment attendance patterns can be empirically-derived and related to efficacy, helping to generate testable hypotheses for follow-up studies that aim to refine interventions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The higher proportion of Droppers in the exercise condition may indicate that the exercise intervention was more aversive or challenging to adhere to.

“The disproportionate number of Droppers in the exercise condition may indicate that the exercise intervention was more aversive or challenging to adhere to.”

Classified as probably not a substantial claim.

If biological verification was unavailable, abstinence was treated as missing data.

“If biological verification was not available to verify self-report, abstinence was considered missing data (Blankers et al., 2016).”

• cites Blankers et al., 2016Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim. May combine two claims.

Self-reported smoking status was verified by expired carbon monoxide at weekly visits and saliva cotinine at follow-up.

“Self-reported smoking status was verified by expired carbon monoxide at weekly visits, and with saliva cotinine at follow-up (SRNT Subcommittee on Biochemical Verification, 2002).”

• cites SRNT Subcommittee on Biochemical Verification, 2002 sourceNot checked — no full text of the source