The AACP established its Clinical Research Award in 1979, which is presented to the author of the best original research paper published in Annals of Clinical Psychiatry during the previous calendar year. The Award is presented at the AACP annual meeting and includes a cash prize, engraved award, complimentary one-year membership to the AACP, plus travel and accommodations to attend the annual meeting. The AACP’s Research Award Committee is responsible for making the selection.

George Winokur Clinical Research Award
Samuel Dotson, M.D.

Rising placebo response rates threaten the validity of antipsychotic meta-analyses

The American Academy of Clinical Psychiatrists George Winokur Research Award has been awarded to Samuel Dotson, M.D. for research that was published in 2019 in the Annals of Clinical Psychiatry, 2019;31(4):249-259. Dr. Dotson will be presented the award at an upcoming AACP Annual Conference (Psychiatry Update 2021). Date to be announced pending COVID restrictions (for further information go to www.CPAACP-CME.com).

The Annals of Clinical Psychiatry provides an international forum for exploring the etiology, diagnosis, and treatment of psychiatric disorders, publishing high-quality, peer-reviewed articles focused on advancing patient care, including original research, timely reviews, case reports, letters to the editor, and book reviews. The Annals are indexed with the National Library of Medicine.

Dr. Dotson’s research article is titled “Rising placebo response rates threaten the validity of antipsychotic meta-analyses”, Annals of Clinical Psychiatry/Vol. 31, No. 4/November 2019. Network meta-analyses (NMAs) are an increasingly important tool in comparative psychopharmacology. As do traditional meta-analyses, these studies assume that there are no unaccounted effect modifiers that could confound comparisons across time. Research methodologies, however, have changed markedly in recent decades. This is clearly seen in rising placebo response rates in modern antipsychotic and antidepressant trials (placebo inflation). The current study aimed to evaluate if NMAs display evidence of a confounding bias that varies with time.

METHOD: Efficacy rankings from 2 landmark antipsychotic meta-analyses were cross-referenced and regressed against FDA approval dates. Two prominent NMAs of antidepressants were analyzed for comparison because these 2 drug classes display distinct patterns of rising placebo response rates.

RESULTS: Newer antipsychotic drugs consistently rank worse than older agents (rho = -0.49, -0.74; p = 0.066, 0.0016). This trend remains robust when excluding outliers (i.e. first generation and non-FDA approved drugs) and analyzing effect sizes rather than efficacy rankings (r = -0.83, -0.77; p = 0.0028, 0.0051). Antidepressant meta-analyses do not display a similar temporal pattern.

CONCLUSIONS: Rankings of antipsychotics, but not antidepressants, show evidence of a confounding temporal bias. Poorly compensated placebo inflation is one potential explanation for this finding.

Dr. Dotson currently oversees a wide variety of departmental education and clinical care efforts as chief resident of community and public psychiatry, chief resident of inpatient medical-psychiatry, and a physician assistant instructor at Massachusetts General Hospital. He serves on the APA Council on Medical Education and Lifelong Learning, and on his Residency Education Policy Committee at Massachusetts General Hospital. Dr. Dotson received his MD in 2017 from the University of North Carolina School of Medicine where he was honored with the George C. Thrasher Jr. Award for Outstanding Student in Psychiatry. He is currently completing the Massachusetts General Hospital and McLean Hospital Combined Adult Psychiatry Residency Program through Harvard Medical School in Boston, Massachusetts.

 

George Winokur Research Award Committee Chair
Carol S. North, M.D., M.P.E.
The Altshuler Ctr. for Education & Research Metrocare
(214) 743-1200
e-mail: [email protected]

George Winokur Award Committee:
Carol S. North, M.D., M.P.E.
Richard Balon, M.D., Wayne State University
James Wilcox, M.D., Ph.D., Seattle, WA
Stacey Smith, M.D., St. Louis, MO

Please contact Beverly Davidson, Executive Director, AACP, for further information at [email protected], or call (920) 395-2330.

 

George Winokur Clinical Research Award Winners

Winners	Runners-up	Committee Chair
1979 David Kupfer, MD	Mark Gold, MD	Charles L. Rich, MD
1980 Larry E. Tune, MD	James R. Morrison, MD Robert E. Smith, MD	Louis Hafken, MD
1981 Hagop S. Akiskal, MD	Henry A. Nasrallah, MD	Louis Hafken, MD
1982 Sheldon H. Preskorn, MD	Larry Kirstein, MD	Louis Hafken, MD
1983 Ming T. Tsuang, MD, PhD	Gary Tollefson, MD, PhD	Louis Hafken, MD
1984 Elizabeth B. Weller, MD	Hector C. Fabelli, MD, PhD	Louis Hafken, MD
1985 Natraj Sitaram, MD	Matig Mavissakalian, MD	Louis Hafken, MD
1986 Dennis S. Charney, MD	Arnold L. Lieber, MD	Louis Hafken, MD
1987 Michael Liebowitz, MD	Harry E. Gwirtsman, MD	Louis Hafken, MD
1988 Ronald A. Weller, MD	Joyce G. Small, MD	Charles L. Rich, MD
1989 Conrad M. Swartz, MD	Timothy D. Brewerton, MD	Valerie F. Holmes, MD
1990 Conrad M. Swartz, MD		Valerie F. Holmes, MD
1991 Douglas Finestone, MD	Ira Glick, MD	Valerie F. Holmes, MD
1992 Roy T. Mathew, MD	Stephen C. Olsen, MD	Valerie F. Holmes, MD
1993 Elizabeth M. Smith, PhD		Valerie F. Holmes, MD
1994 Joesph Magliozzi, MD (co-winner) John Lauer, MD (co-winner)		Paul M. Packman, MD
1995 Laura Sanchez, MD		Paul M. Packman, MD
1996 Mary Fristad, PhD		Paul M. Packman, MD
1997 Danielle S. Schneider, MD		Donald W. Black, MD
1998 Donald W. Black, MD		Donald W. Black, MD
1999 Sidney Zisook, MD		Donald W. Black, MD
2000 Eric Lenze		Donald W. Black, MD
2001 Liviu Ichim MD		Donald W. Black, MD
2002 Paul J. Perry PhD		Donald W. Black, MD
2003 Betty Pfefferbaum, MD		Donald W. Black, MD
2004 (No Award Presented)
2005 Matig Massavikalian, MD		Carol S. North, MD
2006 Pinhas Nedim Dannon, MD		Carol S. North, MD
2007 Keith E. Isenberg, MD		Carol S. North, MD
2008 Ahsan Y. Khan, MD		Carol S. North, MD
2009 George I. Papakostas, MD		Carol S. North, MD
2010 Susan K. Schultz, MD
2011 Doreen Granpeesheh, PhD, BCBA-D		Carol S. North, MD
2012 Alina Suris, PhD, ABPP		Carol S. North, MD
2013 Donald Black, MD		Carol S. North, MD
2014 Boaz Levy, PhD		Carol S. North, MD
2015 Alina Suris		Carol S. North, MD
2016 Mark Zimmerman		Carol S. North, MD
2017 William Lawson, MD, PhD		Carol S. North, MD
2018 Keith E. Isenberg, MD		Carol S. North, MD
2019 Gus Zhang, MD		Carol S. North, MD
2020 Laura Madson, PhD		Carol S. North, MD