Effects of psychological interventions on clinical outcomes in patients with cardiovascular diseases: A systematic review and meta-analysis, 2024

[rvallee]

Effects of psychological interventions on clinical outcomes in patients with cardiovascular diseases: A systematic review and meta-analysis
https://www.sciencedirect.com/science/article/abs/pii/S0022399924003507

Results
A total of 32 studies were included, involving 15,814 patients. Our results showed that psychological interventions could reduce cardiac mortality (RR = 0.81, 95 % CI = 0.68 to 0.96) and the occurrence of myocardial infarction (MI) (RR = 0.79, 95 % CI = 0.69 to 0.89), arrhythmia (RR = 0.61, 95 % CI = 0.42 to 0.89) and angina (RR = 0.92, 95 % CI = 0.87 to 0.97). However, no statistically significant differences were detected in the risk of all-cause mortality, all-cause rehospitalization rates, cardiac rehospitalization rates, revascularization, heart failure (HF), or stroke between the psychological intervention and control groups.

Conclusions
Psychological interventions can reduce cardiac mortality and the occurrence of MI, arrhythmia, and angina in patients with CVDs. It is crucial to incorporate psychological interventions into the existing treatment and management of patients with CVDs. High-quality RCTs should be conducted to explore the optimal psychological intervention methods and the maximum beneficiaries.

 

[rvallee]

The conclusions don't follow the data, about the same as with most of the psychological rehabilitation evidence base for physical illnesses. Big claims in the highlights about lower cardiac mortality and adverse effects, but only out of pooled results with trivial effects that are likely noise caused by interventions that directly seek to influence and manipulate responses. There was no statistical difference for any relevant outcome.

It is crucial to incorporate psychological interventions into the existing treatment and management of patients with CVDs

But they recommend that it is crucial to use them. For what purpose is anyone's guess. More easy copy-paste papers to pad a resume, would be mine.

The most bizarre, and it follows in the usual tradition of useless pragmatic trials in clinical psychology, is that they found 32 randomized trials, which as tradition they mislabeled as RCTs, and their main conclusion is that there should be more. So how many would that take? 64? 128? 256? Where does those pathetic attempts stop? Only when funders have had enough? Until then they basically act as a jobs program, as if clinical trialists can't figure out how to do useful trials? Somehow there's just not enough work to do out there?!

And always this unwavering belief that it's all about finding the optimal intervention for the right people. Which they never, ever, manage to do. No one has ever done that. Out of thousands of nearly identical useless trials. Always potentially useful, if they could figure out how to make it useful, needing far more research. But already useful enough that it's crucial to spend huge resources on it. Which has already happened, with no quantifiable benefits.

The cumulative achievements of the biopsychosocial model of illness remain precisely at zero. Billions wasted on useless nonsense derived from weird 19th century beliefs and not just zero breakthroughs, but not a single bit of actual anything more useful than a magic 8-ball. But it could go on for decades, at least until all of this is made obsolete by technological breakthroughs, which is about the only thing that really matters.