OBJECTIVE A double-blind, randomized controlled trial tested the effectiveness of a personalized Match System in which patients are assigned to therapists with a "track record" of effectively treating a given patient's primary concern(s) (e.g., anxiety). Matched patients demonstrated significantly better outcomes than those assigned through usual pragmatic means. The present study examined patient-level moderators of this match effect. We hypothesized that the match benefits would be especially pronounced for patients who presented with (a) greater overall problem severity, and (b) greater problem complexity (i.e., number of elevated problem domains). We also explored if patient racial/ethnic minority status moderated the condition effect. METHOD Patients were 218 adults randomized to the Match or as-usual assignment condition, and then treated naturalistically by 48 therapists. The primary outcome was the Treatment Outcome Package (TOP), a multidimensional assessment tool that also primed the Match algorithm (based on historical, therapist-level effectiveness data), and assessed trial patients' symptoms/functioning and demographic information at baseline. Moderator effects were tested as patient-level interactions in three-level hierarchical linear models. RESULTS The beneficial match effect was significantly more pronounced for patients with higher initial severity (-0.03, 95% CI -0.05, -0.01) and problem complexity (-0.01, 95% CI -0.02, -0.004), yet the high correlation between severity and complexity called into question the uniqueness of the complexity moderator effect. Moreover, the match effect was more pronounced for racial/ethnic minority patients (i.e., nonwhite; -0.05, 95% CI -0.09, -0.01). CONCLUSIONS Measurement-based matching is especially effective for patients with certain characteristics, which further informs mental health treatment personalization. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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比赛对谁最重要？循证患者-治疗师匹配的患者级调节者。

目标 一项双盲、随机对照试验测试了个性化匹配系统的有效性，在该系统中，患者被分配给具有有效治疗特定患者主要问题（例如焦虑）的“跟踪记录”的治疗师。匹配的患者表现出比通过通常的实用方法分配的患者明显更好的结果。本研究检查了这种匹配效应的患者水平调节剂。我们假设匹配的好处对于表现出（a）更大的整体问题严重性和（b）更大的问题复杂性（即，提升的问题域的数量）的患者来说尤其明显。我们还探讨了患者的种族/少数民族身份是否会减轻病情影响。方法 患者是 218 名成人，随机分配到匹配或照常分配条件下，然后由 48 位治疗师进行自然疗法。主要结果是治疗结果包 (TOP)，这是一种多维评估工具，它还启动了 Match 算法（基于历史、治疗师级别的有效性数据），并在基线时评估试验患者的症状/功能和人口统计信息。调节效应在三级分层线性模型中作为患者级交互进行测试。结果 对于初始严重程度较高（-0.03, 95% CI -0.05, -0.01）和问题复杂性（-0.01, 95% CI -0.02, -0.004）的患者，有益匹配效果显着更显着，但两者之间的相关性较高。严重性和复杂性对复杂性调节效应的独特性提出了质疑。此外，种族/少数民族患者的匹配效应更为明显（即，非白人；-0.05, 95% CI -0.09, -0.01)。结论基于测量的匹配对具有某些特征的患者特别有效，这进一步为心理健康治疗个性化提供了信息。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。