Table I-19, CBT-mixed interventions compared with inactive controls (waitlist, usual care) - Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update

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	Domains Pertaining to Strength of Evidence				Magnitude of Effect	Strength of Evidence
Number of Studies; Number of Subjects	Risk of Bias; Design	Consistency^a	Directness	Precision	Summary Effect Size (95% CI)	High, Moderate, Low, Insufficient
PTSD Symptom Reduction: mean change from baseline to end of treatment for CAPS, all PTSD symptom measures
11; 709 (CAPS) 21; 1349 (all PTSD symptom measures)	Medium; RCTs	Consistent	Direct	Precise	SMD -1.01 (95% CI, -1.28 to -0.74) SMD (CAPS) -1.24 (95% CI, -1.67 to -0.81)	High
Remission (PCL)
1; 44	Medium; RCTs	NA, single study	Direct	Imprecise	0.40	Insufficient
Loss of Diagnosis
9; 474	Medium; RCTs	Consistent	Direct	Precise	RD 0.29 (0.17, 0.40)	High
Prevention/reduction of comorbid depression: mean change from baseline in BDI
15; 929	Medium; RCTs	Consistent	Direct	Precise	SMD -0.87 (95% CI, -1.14 to -0.61)	High
Prevention/reduction of comorbid anxiety: mean change from baseline in STAI
5; 257	Medium; RCTs	Consistent	Direct	Imprecise	WMD, −10.4 (−18.0 to −2.8); 5 trials, N=257; I squared=82.9	Moderate
Quality of Life
5; 416	Medium; RCTs	Inconsistent	Direct	Imprecise	Mixed results (3 of 5 no difference p=ns; 2 of 5 favored CBT-M p<0.05)	Insufficient^a
Disability/functional impairment
6; 350	Medium; RCTs	Consistent	Direct	Imprecise	All trials favored CBT-M, 4 of 6 met statistical significance.	Low^b

a: The use of four difference quality of life measures¹⁴⁹ across the five trials, (one of which included only subscale data, precluded the use of meta-analysis to pool findings). We downgraded the SOE grade for these inconsistencies further due to heterogeneity in measures.
b: We did not use meta-analysis to pool findings because of the diversity of measures used to different aspects of disability and functional impairment. We downgraded the SOE grades for these inconsistencies further due to heterogeneity in measures.
: CI = confidence interval; NA = not applicable; RCT = randomized controlled trial

Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update [Internet].

Comparative Effectiveness Review, No. 207.

Forman-Hoffman V, Middleton JC, Feltner C, et al.

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