Aims The purpose of this review is to examine the replication attempts of psychotherapy clinical trials for depression and anxiety. We focus specifically on replications of trials that exhibit large differences between psychotherapies. The replicability of these trials is especially important for meta-analysis, where the inclusion of false-positive trials can lead to erroneous conclusions about treatment efficacy. Methods Standard replication criteria were developed to distinguish direct from conceptual replication methodologies. Next, an exhaustive literature search was conducted for published meta-analyses of psychotherapy comparisons. Trials that exhibited large effects (d > 0.8) were culled from these meta-analyses. For each trial, a cited replication was conducted to determine if the trial had been subsequently replicated by either ‘direct’ or ‘conceptual’ methods. Finally, a broader search was conducted to examine the extent of replication efforts in the psychotherapy literature overall. Results In the meta-analytic search, a total of N = 10 meta-analyses met the inclusion criteria. From these meta-analyses, N = 12 distinct trials exhibited large effect sizes. The meta-analyses containing more than two large effect trials reported evidence for treatment superiority. A cited replication search yielded no direct replication attempts (N = 0) for the trials with large effects, and N = 4 conceptual replication attempts of average or above average quality. However, of these four attempts, only two partially corroborated the results from their original trial. Conclusion Meta-analytic reviews are influenced by trials with large effects, and it is not uncommon for these reviews to contain several such trials. Since we find no evidence that trials with such large effects are directly replicable, treatment superiority conclusions from these reviews are highly questionable. To enhance the quality of clinical science, the development of authoritative replication criteria for clinical trials is needed. Moreover, quality benchmarks should be considered before trials are included in a meta-analysis, or replications are attempted.

中文翻译：

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心理治疗中的比较临床试验：是否复制了大的效果？

目的 本综述的目的是检查抑郁症和焦虑症心理治疗临床试验的重复尝试。我们特别关注心理疗法之间表现出巨大差异的试验的复制。这些试验的可重复性对于荟萃分析尤其重要，其中包含假阳性试验可能导致关于治疗效果的错误结论。方法 制定了标准复制标准以区分直接复制方法和概念复制方法。接下来，对已发表的心理治疗比较荟萃分析进行了详尽的文献检索。表现出较大影响的试验（d> 0.8）从这些荟萃分析中剔除。对于每个试验，进行引用的复制以确定试验是否随后通过“直接”或“概念”方法进行了复制。最后，进行了更广泛的搜索，以检查整个心理治疗文献中的复制努力程度。结果 在元分析搜索中，共有ñ= 10 项荟萃分析符合纳入标准。从这些荟萃分析中，ñ= 12 项不同的试验表现出较大的效果。包含两个以上大效应试验的荟萃分析报告了治疗优越性的证据。引用的复制搜索没有产生直接复制尝试（ñ= 0) 对于影响较大的试验，以及ñ= 4 次平均或高于平均质量的概念复制尝试。然而，在这四次尝试中，只有两次部分证实了他们最初试验的结果。结论 荟萃分析评论受到影响较大的试验的影响，这些评论包含几个这样的试验并不少见。由于我们没有发现证据表明具有如此大影响的试验可以直接复制，因此这些评价的治疗优越性结论非常值得怀疑。为了提高临床科学的质量，需要制定临床试验的权威复制标准。此外，在将试验纳入荟萃分析或尝试复制之前，应考虑质量基准。