Are the Results Valid?
The study’s focused question
The following study attempts to investigate sex differences among individuals with opioid use disorders who are treated by either buprenorphine maintenance or some other form of treatment (Ling et al., 2019). It does so by posing a focused question on whether buprenorphine is effective for female individuals with opioid use disorders, the numbers of which have been increasing in the past few years.
The study’s use of papers
This article implements randomized controlled trials throughout a number of databases, including PsycINFO, PubMed/Medline, CINAHL, Embase, and Cochrane Central. The aforementioned databases are some of the most widely used and trusted in the sphere of medical research. As such, the authors of the article were able to utilize appropriate studies from good sources.
The study’s inclusion of relevant studies
While the study used a randomized controlled trial for their inclusion of papers, there was also a particular focus on including studies that account for sex differences among tested individuals. References depict studies that also acknowledge several other variables, such as differences based on age, geographic location, and socioeconomic elements.
Assessment of quality of the included studies
The study uses a customized template of the software Covidence. This program is able to navigate components of the papers used in the study by factors such as eligibility criteria, participant demographics, opioid use prior to the study participants, and the duration of the intervention. Collectively with the Cochrane Risk of Bias assessment, these factors were able to ascertain the validity of the used studies.
The Combination of the Results of the Review
The following paper presents the results of the studies separately. The sample sizes of the studies vary, but not by degrees that are highly disproportionate. Similarly, the gender ratios have variations throughout the studies but usually depict the same pattern of fewer female participants. Not combining the results was beneficial to this study in order to observe differences among age groups and locations.
What Are the Results?
The Overall Results of the Review
Initially, the study found that only 52% of the examined studies noted any differences among sex as a variable. Throughout the studies, only 26% of participants were female, with studies focusing on treatment retention, substance use, and sexual risk behaviors. Due to the minimal sample size, the paper concluded that no definitive conclusion could be drawn.
The Precision of the Results
While no confidence intervals are given in the paper, due to the issue faced by the research team with few studies assessing sex differences and the much smaller sample sizes of female participants, no precise result could be deducted. As such, the overall conclusion of the paper states that obstacles such as inconsistent findings and the inability to conduct meta-analyses hindered a precise result.
Will the Results Help Locally?
Application of the Results to the Local Population
A number of studies that occurred in countries in North America were utilized within this review. As such, the study has the potential to implement its findings within countries like the U.S. or Canada. However, the use of the study’s findings elsewhere may not be cohesive with opioid misuse, treatment, and sex differences elsewhere.
Consideration of the Outcomes
The study notes that further research is necessary for the direction of how female and male patients react differently to buprenorphine as a treatment for opioid use disorder. Additionally, further investigation into socioeconomic and cultural backgrounds as a factor is also necessary.
The Benefits, Harms, and Costs
Opioid misuse and use disorders are still especially prevalent in North American countries. The study illustrates that gender disparity may become an issue with the current treatment of opioid use disorder. As such, the benefits would include acknowledging the extent of the issue and formulating strategies to combat this disparity.
The Level of Evidence for the Study
The following review is likely a Level II in terms of the levels of evidence as it uses randomized controlled trials but was unable to conduct a meta-analysis.
Reference
Ling, S., Mangaoil, R., Cleverly, K., Sproule, B., & Puts, M. (2019). A systematic review of sex differences in treatment outcomes among people with opioid use disorder receiving buprenorphine maintenance versus other treatment conditions. Drug and Alcohol Dependence, 197, 168-182.