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Variables which predict response to interventions are described as moderators of treatment effect.8 Despite the existence of a relatively large literature on the effectiveness of low intensity interventions,5 9 10 11 12 there is relatively little rigorous evidence on the critical clinical question of whether initial severity moderates effectiveness of low intensity interventions that is, do more severely ill patients show better or worse treatment effects? Study level meta analyses12 13 of these relationships lack precision and are vulnerable to ecological bias.14 Individual studies often report moderators as secondary analyses, but their yield has been limited by scarcity, selective reporting,15 inappropriate methods,8 16 and low power, as sample sizes required to achieve power to detect moderators are potentially very high.17 This has limited the clinical utility of such analyses. Individual patient data meta analysis has the potential to overcome these difficulties and place clinical decision making in stepped care services on a much firmer Cialis 20mg Online Uk
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