Abstract
Following the publication of the systematic review, we became aware of an oversight in the interpretation of Fig. 3 in the paper related to the comparison of electronically delivered cognitive behavioural therapy (eCBT) versus face to face CBT leading to incorrect interpretation of the figure. We provide an updated figure and an explanation of the source of error in the original manuscript. The quantitative analysis of the depressive symptoms scores was based on the change in the score between pre and post intervention as described in the methods. However, when using this calculated value in the statistical analysis program, the output label is set as the standardized mean difference and the results favoured the less mean score. The oversight occurred by not recognizing that the appropriate label should be “standardized mean difference in change scores”. This oversight led to misinterpretation of the finding and the confusion of the axes stating “favouring” one intervention or the other. The correct interpretation is that the average amount of change was less for eCBT compared to face to face CBT. The text related to this figure should read: we found an estimated mean change of −1.73 (95% CI −2.72, −0.74) showing the average amount of change is less for eCBT compared to face to face CBT. Both models of therapy showed a reduction in depressive symptoms however the reduction was less for eCBT. Sensitivity analysis removing an outlier as presented in the original manuscript supplementary material showed no significant difference in the amount of reduction in symptoms severity between the 2 models (standardized mean difference in change scores SMD −0.79, 95% CI −1.60, 0.02). Post publication comments from readers asked about using post intervention scores and not the change score. We conducted this analysis that shows no significant difference between the 2 models of CBT delivery (SMD 0.21, 95%CI −0.05, 0.46). The overall conclusions are essentially the same stating that eCBT and face to face CBT are effective in reducing depressive symptoms, no differences were seen between the 2 models of delivery in other outcomes including global function, quality of life, participants satisfaction or drop out rates while one study showed eCBT to be less costly. Considering all factors and limitations, eCBT is as effective as face to face CBT and should be considered as a treatment option if preferred by patients and therapists as originally stated. A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysisAlthough we found eCBT to have moderate evidence of effectiveness in reducing symptoms of depression, high heterogeneity among studies precludes definitive conclusions for all outcomes. With the current reliance and accessibility of technology to increasing number of people worldwide, serious consideration in utilizing technology should be given to maximize accessibility for depression treatments. Our results found eCBT is at least as effective as face to face CBT, thus eCBT should be offered if preferred by patients and therapists. Full-Text PDF Open Access
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