Music Therapy Versus Cognitive Behavioral Therapy via Telehealth for Anxiety in Survivors of Cancer: A Randomized Clinical Trial.

Cognitive behavioral therapy (CBT) is the first-line treatment, but not all individuals have access, respond to treatment, or prefer this option because of stigma.

认知行为疗法（CBT）是首选治疗方法，但并非所有人都能获得治疗，对治疗有反应，或因污名化而偏好这种选项。

Music therapy is effective for short-term anxiety reduction, but it is unknown whether it is noninferior to first-line CBT for long-term anxiety reduction.

音乐疗法对于短期焦虑减轻是有效的，但尚不清楚它是否与一线认知行为疗法（CBT）在长期焦虑减轻方面具有非劣效性。

Methods

This comparative effectiveness trial randomly assigned English- or Spanish-speaking survivors of cancer to seven weekly telehealth sessions of music therapy or CBT.

这项比较有效性试验随机分配了说英语或西班牙语的癌症幸存者，接受七周的音乐疗法或CBT远程医疗会话。

The coprimary end points were changes in the Hospital Anxiety and Depression Scale (HADS) anxiety score at weeks 8 and 26.

主要终点是第8周和第26周时医院焦虑抑郁量表（HADS）焦虑评分的变化。

The noninferiority margin was 0.35 standard deviations, informed by a minimal clinically important difference (MCID) of 1.7 points.

非劣效性边界为0.35个标准差，这是基于最小临床重要差异（MCID）为1.7分的信息。

Secondary outcomes included fatigue, depression, insomnia, pain, cognitive dysfunction, and health-related quality of life.

次要结果包括疲劳、抑郁、失眠、疼痛、认知功能障碍以及与健康相关的生活质量。

Results

Among N = 300 patients, 74.7% was female, 76.5% was White, and 19.0% was Hispanic.

在N=300名患者中，74.7%为女性，76.5%为白人，19.0%为西班牙裔。

At week 8, the mean change in HADS anxiety score was -3.12 (95% CI, -3.59 to -2.65) in music therapy and -2.97 (95% CI, -3.45 to -2.50) in CBT; the between-group difference was -0.15 (95% CI, -0.78 to 0.49), within the noninferiority margin of 1.20 (P < .001).

在第8周时，音乐疗法组的HADS焦虑评分平均变化为-3.12（95%置信区间，-3.59至-2.65），认知行为疗法（CBT）组为-2.97（95%置信区间，-3.45至-2.50）；两组之间的差异为-0.15（95%置信区间，-0.78至0.49），在非劣效性边界值1.20之内（P < .001）。

At week 26, the mean change was -3.31 (95% CI, -3.78 to -2.85) in music therapy and -3.00 (95% CI, -3.47 to -2.53) in CBT; the between-group difference was -0.31 (95% CI, -0.95 to 0.32), within the noninferiority margin of 1.28 (P < .001).

在第26周时，音乐疗法组的平均变化为-3.31（95%置信区间，-3.78至-2.85），CBT组为-3.00（95%置信区间，-3.47至-2.53）；两组之间的差异为-0.31（95%置信区间，-0.95至0.32），在非劣效性边界值1.28之内（P < .001）。

Both groups produced anxiety reductions exceeding the MCID and showed similar improvements in secondary outcomes.

两组均产生了超过最小临床重要差异（MCID）的焦虑减轻，并在次要结果指标上显示出相似的改善。

Conclusions

Music therapy is noninferior to CBT for anxiety in survivors of cancer.

音乐疗法对于癌症幸存者的焦虑治疗效果不劣于认知行为疗法（CBT）。

Both telehealth interventions produced clinically meaningful, durable improvements in anxiety.

两种远程医疗干预措施均产生了具有临床意义且持久的焦虑改善效果。